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Published in: BMC Musculoskeletal Disorders 1/2018

Open Access 01-12-2018 | Research article

Level of participation in physical therapy or an internet-based exercise training program: associations with outcomes for patients with knee osteoarthritis

Authors: Megan Pignato, Liubov Arbeeva, Todd A. Schwartz, Leigh F. Callahan, Jennifer Cooke, Yvonne M. Golightly, Adam P. Goode, Bryan C. Heiderscheit, Carla Hill, Kim M. Huffman, Herbert H. Severson, Kelli D. Allen

Published in: BMC Musculoskeletal Disorders | Issue 1/2018

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Abstract

Background

To examine whether number of physical therapy (PT) visits or amount of use of an internet-based exercise training (IBET) program is associated with differential improvement in outcomes for participants with knee osteoarthritis (OA).

Methods

A secondary analysis was performed using data from participants in 2 arms of a randomized control trial for individuals with symptomatic knee OA: PT (N = 135) or IBET (N = 124). We examined associations of number of PT visits attended (up to 8) or number of days the IBET website was accessed during the initial 4-month study period with changes in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total, pain and function subscales, as well as a 2-min Step Test, at 4-month and 12-month follow-up.

Results

Participants with more PT visits experienced greater improvement in WOMAC total score (estimate per additional visit = − 1.18, CI 95% = − 1.91, 0.46, p <  0.001) and function subscore (estimate = − 0.80, CI 95% = − 1.33, − 0.28, p <  0.001) across follow-up periods. For WOMAC pain subscale, the association with number of PT visits varied significantly between 4- and 12-month follow-up, with a stronger relationship at 4-months. There was a non-significant trend for more PT visits to be associated with greater improvement in 2-min Step Test. More frequent use of the IBET website was not associated with greater improvement for any outcome, at either time point.

Conclusion

Increased number of PT visits was associated with improved outcomes, and some of this benefit persisted 8 months after PT ended. This provides guidance for PT clinical practice and policies.

Trial registration

NCT02312713, posted 9/25/2015.
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Metadata
Title
Level of participation in physical therapy or an internet-based exercise training program: associations with outcomes for patients with knee osteoarthritis
Authors
Megan Pignato
Liubov Arbeeva
Todd A. Schwartz
Leigh F. Callahan
Jennifer Cooke
Yvonne M. Golightly
Adam P. Goode
Bryan C. Heiderscheit
Carla Hill
Kim M. Huffman
Herbert H. Severson
Kelli D. Allen
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2018
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-018-2139-y

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