130.
Efficacy of neuromuscular exercise in patients with severe
osteoarthritis of the hip or knee: A randomised controlled trial
Allan Villadsen, Søren Overgaard, Anders Holsgaard-Larsen, Robin
Christensen, Ewa Roos
Research Unit for Musculoskeletal Function and Physiotherapy, Inst. of Sports
Sciences and Clinical University of Southern Denmark; Orthopaedic Research
Unit, Dept. of Orthopaedics and Traumatology, Odense University Hospital ;
Orthopaedic Research Unit, Dept. of Orthopaedics and Traumatology, Odense
University Hospital; Musculoskeletal Statistics Unit, The Parker Institute,
Department of Rheumatology, Copenhagen Universtiy Hospital Frederiksberg;
Research Unit for Musculoskeletal Function and Physiotherapy, Inst. of Sports
Sciences and Clinical , University of Southern Denmark
Background:
Knowledge about the effects of exercise in severe and end-stage
osteoarthritis (OA) is sparse.
Purpose / Aim of Study:
The aim was to evaluate the efficacy of a
neuromuscular exercise programme in patients with severe hip or knee OA.
Materials and Methods:
Design. Randomised controlled assessor-blinded
trial. Intervention. Educational package (care-as-usual) only, or care-as-usual
plus an 8-week neuromuscular exercise intervention (NEMEX-TJR). NEMEX-
TJR was supervised by a physiotherapist, twice weekly for one hour. Primary
outcome. HOOS/KOOS questionnaire subscale ADL. Secondary outcomes.
HOOS/KOOS subscales Pain, Symptoms, Sport & Recreation and Joint-
Related Quality of Life.
Findings / Results:
165
patients, 56% females, average age 67 (SD 8) years
and a body mass index of 30 (SD 5), scheduled for primary hip or knee
arthroplasty, were included. The post-intervention difference between mean
changes in ADL was 7.2 points (95% CI 3.5 to 10.9, p = .0002) in favour of
NEMEX-TJR compared with control. Secondly, there were statistically
significant differences between groups in favour of NEMEX-TJR on all self-
reported outcomes. Stratified analyses according to joint revealed moderate
effect size for ADL for hip patients (0.63, 95% CI .26 to 1.00). Corresponding
effect size for knee patients was small (0.23 95% CI -.14 to .60).
Conclusions:
Neuromuscular exercise improves self- reported activities of
daily living and reduces pain. It constitutes a viable treatment option for
patients with severe hip or knee OA assigned for total hip or knee arthroplasty.
Clinical trial identifier: NCT01003756
