None listed
Conditions
Brief summary
Osteoarthritis (OA) is a common condition affecting the hip and knee. Due to factors such as the ageing population and the increasing prevalence of obesity, the incidence of severe osteoarthritis is increasing. Severe osteoarthritis can warrant referral to an orthopaedic surgeon for an opinion on the appropriateness of total joint replacement as a management option. People with severe osteoarthritis often wait for long periods of time in the public health system before being seen by an orthopaedic surgeon. Before surgical intervention is considered, exercise programs to improve strength and function can help to alleviate symptoms and potentially improve outcomes following eventual arthroplasty surgery. The duration, quality, and effectiveness of currently available programs is varied. The literature suggests that exercise programs are more effective if they are supervised and if they are at least 12 weeks in duration given the time required for neuromuscular adaptation to take place. Kieser Australia has developed a 14-week supervised exercise program for people with hip or knee osteoarthritis on the waitlist to be seen by an orthopaedic surgeon for consideration of total joint replacement surgery. Aim - to determine the feasibility of the supervised exercise program in terms of recruitment rate, participant adherence, and participant retention.
Interventions
- Program consists of 8 Physiotherapy sessions - Including a 60-minute initial assessment and 7x30min follow up sessions (advice, education, gym rehab program set up, gym rehab program progression/alteration based on assessment, manual therapy as required)
- 8 one on one supervised gym rehab sessions (machine-based strength program tailored to each patient, including quadriceps, gluteal, hamstring, calf exercises + supplementary core, lumbar, pelvic, thoracic and upper limb exercises as required
- Program consists of 8 Physiotherapy sessions - Including a 60-minute initial assessment and 7x30min follow up sessions (advice, education, gym rehab program set up, gym rehab program progression/alteration based on assessment, manual therapy as required) - 8 one on one supervised gym rehab sessions (machine-based strength program tailored to each patient, including quadriceps, gluteal, hamstring, calf exercises + supplementary core, lumbar, pelvic, thoracic and upper limb exercises as required) - 12-weeks of independent gym rehab (machine-based strength program tailored to each patient, including quadriceps, gluteal, hamstring, calf exercises + supplementary core, lumbar, pelvic, thoracic and upper limb exercises as required) - Independent home exercise program following – via Kieser App – exercise tailored to suit individual. -overall duration = 26 weeks -Supervised + delivered by Physiotherapists -Total one on one sessions = 16 (8x Physio + 8x gym rehab) -Refer to figure in Project Description (top of page 6 of attached document later in this form - under study protocol) for timing of one on one sessions (2nd and 3rd columns, figure 1, schedule of assessments) -Intensity of exercises = moderate/high, assessed via Borg RPE (via Kieser App) -Exercise examples, resisted machine based in sitting = leg press, hip abduction, knee extension, knee flexion. Home exercises = side lying hip abduction, double leg bridge, straight leg raise, weighted prone knee flexion -App = machine based training program logged (e.g. session date/attendance, machines utilised, resistance, time under load, Borg RPE for overall session). App home based exercises = diagrams with instructions (sets/reps) -As intervention is individualised (based on participant current strength, pain levels, functional ability), each program is set up on the App for each participant separately (treating Physiotherapist is responsible for setting the program in the App)
Sponsors
St. Vincent's Hospital Melbourne
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
40 Years to No maximum
Healthy volunteers
No
Inclusion criteria
a. Knee or Hip Osteoarthritis demonstrated on imaging b. 40 years of age or above c. VAS 4/10 or greater d. Waitlist category 2 or 3 only e. Body mass index (BMI) < 40 f. Lives within reasonable distance to a Kieser location: i. Bendigo ii. Brighton iii. Burwood East iv. Camberwell v. Caulfield vi. Collingwood vii. Collins Street (CBD) viii. Essendon ix. Geelong x. Heidelberg xi. Malvern xii. Mont Albert xiii. Mornington xiv. Northcote xv. Ocean Grove xvi. Ringwood xvii. Sandringham xviii. South Melbourne xix. Spotswood xx. Torquay xxi. Werribee g. Willing to participate in 14-week program (stress the importance of compliance/consistent attendance) h. Able to communicate effectively – English speaking only (stress the importance of compliance/consistent attendance) i. Referred by OAHKS (Osteoarthritis Hip and Knee Service) Team/Orthopaedic Team to Kieser (direct referral process) j. Consents to de-identified data being collected by Kieser Australia for the purpose of research
Exclusion criteria
Exclusion criteria: Patients meeting the following criteria will not partake in isometric strength testing a. Acute pain or inability to tolerate the test b. Osteoporosis or osteopenia c. Uncontrolled high Blood Pressure or heart issues
Outcome results
None listed