Effectiveness of Supervised and Unsupervised Exercise Protocol on Pain, Range of Motion, and Physical Function in Knee Osteoarthritis Patients

Abstract

Introduction: Osteoarthritis (OA) is a prevalent joint disorder worldwide, particularly among the elderly, and poses a significant health challenge in many societies. Also referred to as degenerative arthritis, it primarily impacts the hands, feet, spine, and large weight- bearing joints like the hips and knees. Physical therapy, particularly rehabilitation exercises aimed at strengthening the muscles around the knee, enhancing range of motion, and alleviating pain, plays a vital role in the non-surgical treatment of OA. These exercises often require patients to attend specialized clinics for multiple sessions to achieve optimal results. Tele-rehabilitation (tele-rehab), which uses information and communication technology to deliver services remotely, offers the potential for reduced transportation costs, saving time and treatment expenses. Comparing the effectiveness of these two treatment methods can help shape better management strategies for knee OA patients, leading to improved outcomes and more efficient healthcare delivery.

MATERIALS AND METHODS: This study is a randomised controlled trial (RCT), in which we compared the effect of exercises protocol on pain, range of motion and physical function on knee osteoarthritis via supervised (in person) and unsupervised (tele rehab) mode of treatment

RESULTS: Comparing the two groups, the results revealed no significant difference between the supervised and unsupervised groups in terms of the overall improvement across the measured outcomes. Both the supervised and unsupervised groups demonstrated significant improvements in pain, physical function, and knee joint range of motion following the intervention. However, the supervised group exhibited more pronounced outcomes across all variables. Specifically, the supervised group showed significantly greater reductions in pain, both at rest (NPRS REST) and during activity (NPRS ACTIVITY), as well as more substantial improvements in physical function (WOMAC index) and range of motion, with all results yielding p-values < 0.0001. Although the unsupervised group also experienced notable improvements, the supervised group showed superior gains, indicating the added benefit of in-person supervision in the rehabilitation process.

CONCLUSION: In summary, while both supervised and unsupervised exercise protocols are beneficial for managing knee OA, supervised in-person therapy offers superior outcomes in reducing pain, improving ROM, and enhancing physical function. The personalized guidance, immediate feedback, enhanced motivation, and structured environment provided in supervised settings contribute to these superior results. Healthcare providers must take these factors into account when designing treatment plans for knee OA patients, aiming to incorporate supervised exercise interventions to maximize therapeutic benefit.