Effectiveness of Internet-Based Exercises Aimed at Treating Knee Osteoarthritis : The iBEAT-OA Randomized Clinical Trial
(2021) In JAMA Network Open 4(2). p.210012-210012- Abstract
Importance: Osteoarthritis is a prevalent, debilitating, and costly chronic disease for which recommended first-line treatment is underused.
Objective: To compare the effect of an internet-based treatment for knee osteoarthritis vs routine self-management (ie, usual care).
Design, Setting, and Participants: This randomized clinical trial was conducted from October 2018 to March 2020. Participants included individuals aged 45 years or older with a diagnosis of knee osteoarthritis recruited from an existing primary care database or from social media advertisements were invited. Data were analyzed April to July 2020.
Interventions: The intervention and control group conformed to first-line knee osteoarthritis treatment.... (More)
Importance: Osteoarthritis is a prevalent, debilitating, and costly chronic disease for which recommended first-line treatment is underused.
Objective: To compare the effect of an internet-based treatment for knee osteoarthritis vs routine self-management (ie, usual care).
Design, Setting, and Participants: This randomized clinical trial was conducted from October 2018 to March 2020. Participants included individuals aged 45 years or older with a diagnosis of knee osteoarthritis recruited from an existing primary care database or from social media advertisements were invited. Data were analyzed April to July 2020.
Interventions: The intervention and control group conformed to first-line knee osteoarthritis treatment. For the intervention group, treatment was delivered via a smartphone application. The control group received routine self-management care.
Main Outcomes and Measures: The primary outcome was change from baseline to 6 weeks in self-reported pain during the last 7 days, reported on a numerical rating scale (NRS; range, 0-10, with 0 indicating no pain and 10, worst pain imaginable), compared between groups. Secondary outcomes included 2 physical functioning scores, hamstring and quadriceps muscle strength, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and quantitative sensory testing.
Results: Among a total of 551 participants screened for eligibility, 146 were randomized and 105 were analyzed (mean [SD] age, 66.7 [9.2] years, 71 [67.1%] women), including 48 participants in the intervention group and 57 participants in the control group. There were no significant differences in baseline characteristics between the groups. At the 6-week follow-up, the intervention group showed a greater NRS pain score reduction than the control group (between-group difference, -1.5 [95% CI, -2.2 to -0.8]; P < .001). Similarly, the intervention group had better improvements in the 30-second sit-to-stand test (between-group difference, 3.4 [95% CI, 2.2 to 4.5]; P < .001) and Timed Up-and-Go test (between-group difference, -1.8 [95% CI, -3.0 to -0.5] seconds; P = .007), as well as the WOMAC subscales for pain (between-group difference, -1.1 [95% CI, -2.0 to -0.2]; P = .02), stiffness (between-group difference, -1.0 [95% CI, -1.5 to -0.5]; P < .001), and physical function (between-group difference, -3.4 [95% CI, -6.2 to -0.7]; P = .02). The magnitude of within-group changes in pain (d = 0.83) and function outcomes (30 second sit-to-stand test d = 1.24; Timed Up-and-Go test d = 0.76) in the intervention group corresponded to medium to very strong effects. No adverse events were reported.
Conclusions and Relevance: These findings suggest that this internet-delivered, evidence-based, first-line osteoarthritis treatment was superior to routine self-managed usual care and could be provided without harm to people with osteoarthritis. Effect sizes observed in the intervention group corresponded to clinically important improvements.
Trial Registration: ClinicalTrials.gov Identifier: NCT03545048.
(Less)
- author
- Gohir, Sameer Akram ; Eek, Frida LU ; Kelly, Anthony ; Abhishek, Abhishek and Valdes, Ana M
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Aged, Exercise Therapy/methods, Female, Hamstring Muscles, Humans, Internet-Based Intervention, Male, Middle Aged, Muscle Strength, Osteoarthritis, Knee/physiopathology, Physical Functional Performance, Quadriceps Muscle, Self-Management, Treatment Outcome
- in
- JAMA Network Open
- volume
- 4
- issue
- 2
- pages
- 210012 - 210012
- publisher
- American Medical Association
- external identifiers
-
- pmid:33620447
- scopus:85101936584
- ISSN
- 2574-3805
- DOI
- 10.1001/jamanetworkopen.2021.0012
- language
- English
- LU publication?
- yes
- id
- 3ac30ef6-f048-49cd-ba4d-46fe580dc27a
- date added to LUP
- 2021-05-12 09:29:04
- date last changed
- 2024-06-16 13:39:20
@article{3ac30ef6-f048-49cd-ba4d-46fe580dc27a,
abstract = {{<p>Importance: Osteoarthritis is a prevalent, debilitating, and costly chronic disease for which recommended first-line treatment is underused.</p><p>Objective: To compare the effect of an internet-based treatment for knee osteoarthritis vs routine self-management (ie, usual care).</p><p>Design, Setting, and Participants: This randomized clinical trial was conducted from October 2018 to March 2020. Participants included individuals aged 45 years or older with a diagnosis of knee osteoarthritis recruited from an existing primary care database or from social media advertisements were invited. Data were analyzed April to July 2020.</p><p>Interventions: The intervention and control group conformed to first-line knee osteoarthritis treatment. For the intervention group, treatment was delivered via a smartphone application. The control group received routine self-management care.</p><p>Main Outcomes and Measures: The primary outcome was change from baseline to 6 weeks in self-reported pain during the last 7 days, reported on a numerical rating scale (NRS; range, 0-10, with 0 indicating no pain and 10, worst pain imaginable), compared between groups. Secondary outcomes included 2 physical functioning scores, hamstring and quadriceps muscle strength, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and quantitative sensory testing.</p><p>Results: Among a total of 551 participants screened for eligibility, 146 were randomized and 105 were analyzed (mean [SD] age, 66.7 [9.2] years, 71 [67.1%] women), including 48 participants in the intervention group and 57 participants in the control group. There were no significant differences in baseline characteristics between the groups. At the 6-week follow-up, the intervention group showed a greater NRS pain score reduction than the control group (between-group difference, -1.5 [95% CI, -2.2 to -0.8]; P < .001). Similarly, the intervention group had better improvements in the 30-second sit-to-stand test (between-group difference, 3.4 [95% CI, 2.2 to 4.5]; P < .001) and Timed Up-and-Go test (between-group difference, -1.8 [95% CI, -3.0 to -0.5] seconds; P = .007), as well as the WOMAC subscales for pain (between-group difference, -1.1 [95% CI, -2.0 to -0.2]; P = .02), stiffness (between-group difference, -1.0 [95% CI, -1.5 to -0.5]; P < .001), and physical function (between-group difference, -3.4 [95% CI, -6.2 to -0.7]; P = .02). The magnitude of within-group changes in pain (d = 0.83) and function outcomes (30 second sit-to-stand test d = 1.24; Timed Up-and-Go test d = 0.76) in the intervention group corresponded to medium to very strong effects. No adverse events were reported.</p><p>Conclusions and Relevance: These findings suggest that this internet-delivered, evidence-based, first-line osteoarthritis treatment was superior to routine self-managed usual care and could be provided without harm to people with osteoarthritis. Effect sizes observed in the intervention group corresponded to clinically important improvements.</p><p>Trial Registration: ClinicalTrials.gov Identifier: NCT03545048.</p>}},
author = {{Gohir, Sameer Akram and Eek, Frida and Kelly, Anthony and Abhishek, Abhishek and Valdes, Ana M}},
issn = {{2574-3805}},
keywords = {{Aged; Exercise Therapy/methods; Female; Hamstring Muscles; Humans; Internet-Based Intervention; Male; Middle Aged; Muscle Strength; Osteoarthritis, Knee/physiopathology; Physical Functional Performance; Quadriceps Muscle; Self-Management; Treatment Outcome}},
language = {{eng}},
number = {{2}},
pages = {{210012--210012}},
publisher = {{American Medical Association}},
series = {{JAMA Network Open}},
title = {{Effectiveness of Internet-Based Exercises Aimed at Treating Knee Osteoarthritis : The iBEAT-OA Randomized Clinical Trial}},
url = {{http://dx.doi.org/10.1001/jamanetworkopen.2021.0012}},
doi = {{10.1001/jamanetworkopen.2021.0012}},
volume = {{4}},
year = {{2021}},
}