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Self-management exercise program associated to spa therapy increased the physical activity level of people with symptomatic knee osteoarthritis: a quasi-randomized controlled trial
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BackgroundTreating knee osteoarthritis (OA) in the medical phase is today well standardized. Guideline orientated approaches aiming at increasing physical activity (PA), improving pain and disability.ObjectivesTo assess effectiveness of self-management exercise program associated to spa therapy at 3 month on the improvement of physical activity (PA) level, disability, pain, anxiety, fears and believes in symptomatic knee osteoarthritis people.MethodsProspective, multicentric, quasi-randomized controlled trial with alternate month design method (one month periods). People with symptomatic knee OA people (stage I-IV, Kelgren and Lawrence scale) with low and moderate PA level were included in 3 spa therapy resorts. Intervention group (IG) received 5 self-management exercise sessions (1h30; education, aerobic, strength training, range of motion) + information booklet + 18 sessions (1h) of conventional spa therapy (STC). Control group (CG) received information booklet + 18 sessions of STC. The primary outcome was changes at 3 months in PA level (IPAQ short form score) and secondary outcomes were WOMAC function, pain (VAS), HAD anxiety/depression, KOFBeQ fears and believes changes.Results 131 subjects were included. The mean age was 65.6 years [± 6.7]. WOMAC function score was 22.1/68 [±11.3] and pain was 4.6/10 [± 1.9] at inclusion. Both groups significantly increased PA level measured with continuous IPAQ total score (MET-minutes/weeks), with superiority for IG (+77.8%; p=0.0062) than CG (+50.7%; p=0.0099). There was no change in setting time. Disability (-11.3%; p=0.0370) and pain (-15.2%; p=0.0032) also decreased significantly for both groups. Anxiety (-11.6%; p=0.0195) and fears and believes (-18.2%; p=0.0146) decreased significantly only in intervention group. Other data will be presented later
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