Effectiveness of a Blended Physical Therapist Intervention in People With Hip Osteoarthritis, Knee Osteoarthritis, or Both: A Cluster-Randomized Controlled Trial.
Corelien J J Kloek, Daniël Bossen, Peter M Spreeuwenberg and 3 others
PMID 29788253WHAT IT FOUND
Blended physical therapy with online support was not more effective than usual care for hip or knee osteoarthritis.
Both groups improved similarly in function and pain, but the blended group required fewer face-to-face sessions.
Key findings
01No statistically significant differences were seen between e-Exercise and usual physical therapy for primary outcomes of physical functioning and physical activity at 3 months.
02At 12 months, there were still no statistically significant differences between groups for the primary outcome measures.
03Participants in the usual physical therapy group received an average of 12 sessions, whereas those in the e-Exercise group received an average of 5 sessions.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
High dropout rates occurred, with 15% lost to follow-up at 3 months and 35% at 12 months, which may bias the results. Objective physical activity data were missing for a large portion of participants (49% missing at 12 months). The study population was already physically active at baseline, leaving little room for improvement in activity levels. Physical therapists were not masked to group allocation, which could influence treatment delivery or assessment. Diagnosis of osteoarthritis was not confirmed by an independent clinician.
Declared interests
The study was funded by ZonMw, the Dutch Rheumatoid Arthritis Foundation, and the Royal Dutch Society for Physiotherapy. The funders played no role in the conduct of the study.
The easy way to misread this
Do not assume that the blended e-Exercise intervention is superior for increasing physical activity. While subjective activity increased in the e-Exercise group, objective measures showed no significant improvement in either group, and sedentary behavior actually increased more in the e-Exercise group than in usual care.