Home exercise supported by electronic tools can lead to small improvements in pain, physical function, and health-related quality of life in individuals with osteoarthritis of the knee

Schafer AGM, Zalpour C, von PH, et al.  The efficacy of electronic health-supported home exercise interventions for patients with osteoarthritis of the knee: Systematic review  Journal of Medical Internet Research. 2018, ;20(4): e152.

Review question

• Is home exercise supported by electronic tools effective in relieving pain and improving physical function in individuals with osteoarthritis of the knee?

Background

• Due to joint stiffness and instability, individuals living with osteoarthritis of the knee suffer from chronic pain and have limited mobility.
• These individuals need to exercise regularly at home to manage their pain and symptoms. However, they often find it difficult to maintain their exercise routine, due to a lack of motivation, feedback and personal interactions.
• Electronic tools (also known as eHealth tools) refer to technology (for example, internet-based programs or apps) that can be used to provide patient education, instructions for self-management, motivation, monitoring, feedback and reminders, and to enable communication.
• Research evidence revealed positive effects of such electronic tools for other chronic diseases like chronic pain, cardiovascular disease and diabetes, but little is known about the effects for osteoarthritis of the knee.

How the review was done

• A detailed search of four electronic databases was conducted to find studies published up to July 2017. Studies that focused on home-exercise interventions for individuals with osteoarthritis of the knee who are supported by electronic tools were included in the systematic review.
• A total of 537 studies were identified in searches, and seven were included in the review after assessing their eligibility.
• The review did not mention any funding source.

What the researchers found

• The systematic review found that home-exercise interventions supported by electronic tools resulted in less pain, improved physical function, and health-related quality of life compared with no or other interventions.
• However, improvements were small and it is possible that they do not make a meaningful difference for individual patients living with osteoarthritis of the knee.
• When comparing electronic tools, mobile apps seem to be generally more effective than telephone support.

Conclusion

• The review found home-exercise interventions supported by electronic tools make small beneficial changes in the short and long term for pain and physical function for inviduals living with osteoarthritis of the knee.