Abstract
Introduction: Knee osteoarthritis (KOA) stands out as the most common synovial joint disease among people, leading to a reduced quality of life, persistent pain, muscle weakness, and significant functional impairments. The aim of this study is to carry out an investigation that assesses the efficacy of clinic-supervised and internet-based exercise therapy (IET) on pain, range of knee flexion, and physical function of patients with KOA.
Methods: This randomized controlled trial enrolled 54 patients between the ages of 50 and 75, all of whom had confirmed KOA. These patients were randomly allocated to one of two groups, both of which underwent 18 sessions of exercise therapy. One group received supervised therapy, while the other received therapy delivered via the internet. The study measured various outcomes, including pain intensity assessed with the VAS, thigh girth (TG), knee active flexion range of motion (FROM), the six-minute walk test (6MWT), the timed up and go test (TUG), and knee functionality evaluated using the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) questionnaire, both before and after the intervention. We used the paired t-test for intra-group analysis and the independent samples t-test and analysis of covariance (ANCOVA) test to compare differences between the groups.
Results: Significant differences in outcomes were observed before and after the intervention in both groups (P=0.001). However, the ANCOVA test revealed no significant differences between the groups following the study. The statistical analysis, performed with an independent-samples t-test, indicated no significant differences between the two groups concerning VAS, active knee flexion, thigh girth, and WOMAC scores, suggesting that both supervised exercise therapy (SET) and IET protocols yielded similar effectiveness. Nevertheless, when employing the independent-samples t-test, there were significant differences between the groups in the TUG (P=0.001) and the 6MWT (P=0.017), with the IET group demonstrating superior performance.
Conclusion: The results of this study indicate that both SET and IET produce comparable outcomes in terms of reducing pain, increasing thigh girth, increasing knee flexion range, and improving WOMAC scores and the physical function of patients with KOA. The internet-based approach may offer added convenience and motivation for patients.