Home-Based Remote Rehabilitation Leads to Superior Outcomes for Older Women With Knee Osteoarthritis: A Randomized Controlled Trial

Objectives: To examine the effects of a home-based lower-extremity strengthening exercise program in community-dwelling older women with knee osteoarthritis.Design: Randomized controlled trial.Setting and Participants: Women aged >= 60 years with knee osteoarthritis and Kellgren-Lawrence grade 1 or 2 on anteroposterior/lateral radiographs of both knee joints.Methods: Patients (n = 36) were randomly divided into experimental (EG) and control (CG) groups. The EG performed home-based remote rehabilitation lower-extremity strengthening exercises for 8 weeks, whereas the CG received no intervention. Assessment was performed at baseline and week 8. The primary outcome was the five-times sit-to-stand test (FTSST) result. Secondary outcomes included timed up-and-go (TUG) test results, knee extensor and flexor strength, quadriceps (rectus femoris) muscle activity, skeletal muscle index, blood pressure (BP), visual analog scale (VAS) scores, C-reactive protein level, and erythrocyte sedimentation rate.Results: A statistically significant difference in the FTSST times was observed between the groups after 8 weeks of intervention (EG: 7.95 +/- 1.08 seconds, CG: 10.01 +/- 2.03 seconds, P < .001). In the EG, the TUG test score decreased by 0.75 +/- 0.80 seconds (P = .002), right and left knee flexor strength increased by 4.69 +/- 6.05 kg (P = .007) and 3.98 +/- 6.98 kg (P = .038), respectively, and the right knee extensor root mean square (RMS) ratio increased by 1.24 +/- 0.39 (P = .027). Additionally, systolic and diastolic BP decreased by 9.50 +/- 10.75 mm Hg (P = .005) and 4.25 +/- 4.91 mm Hg (P = .003), respectively. In the CG, the VAS scores decreased by 9.10 +/- 13.68 mm (P = .022). Conclusions and Implications: The home-based exercise program using a remote rehabilitation medical device was effective in improving lower extremity strength and function in community-dwelling older women with knee osteoarthritis. This finding suggests that the remote rehabilitation medical device may be used as an alternative to exercise interventions for patients with knee osteoarthritis. (c) 2023 AMDA -The Society for Post-Acute and Long-Term Care Medicine.