Both exercise and pain-coping skills training have been shown to be beneficial in patients with osteoarthritis of the knee, which affects approximately 25% of all adults. Accessing specialists who can provide such care, however, may be difficult, especially for those living in rural areas. An Internet-based intervention combining physiotherapist-prescribed home exercise, pain-coping skills training, and educational materials was evaluated in a parallel-group, pragmatic, randomized controlled trial.

A total of 148 community-dwelling adults ages 50 or older with chronic knee pain and mild-to-moderate physical dysfunction were enrolled in the study. Via the Internet, participants accessed online educational materials, an interactive automated pain-coping skills training program that included one training module per week and daily practice in pain-coping skills, and seven Skype sessions with a physiotherapist over the course of 12 weeks. The physiotherapist prescribed a home exercise program to be performed three times a week. The control group received the same educational materials as the intervention group.

At three months, the intervention group reported significantly greater improvements in pain and physical function, as determined by valid self-reported measures, compared with the control group. These improvements were sustained at nine months. In comparison to the control group, intervention group participants also showed significant improvements in most secondary outcomes, including knee pain during the past 48 hours and quality of life. At both three and nine months, significantly more intervention group than control group participants reported global improvements.

The authors note that this intervention was accessed by partic-ipants in rural and urban areas, and participants reported high satisfaction with it. They conclude that this intervention could provide a safe, effective, and viable alternative to traditional treatment delivery.-KR

REFERENCE