{"id":144050,"date":"2020-12-29T19:33:58","date_gmt":"2020-12-29T16:33:58","guid":{"rendered":"https:\/\/en.buradabiliyorum.com\/stepped-approach-to-exercise-can-help-with-arthritic-knees\/"},"modified":"2020-12-29T19:33:58","modified_gmt":"2020-12-29T16:33:58","slug":"stepped-approach-to-exercise-can-help-with-arthritic-knees","status":"publish","type":"post","link":"https:\/\/buradabiliyorum.com\/en\/stepped-approach-to-exercise-can-help-with-arthritic-knees\/","title":{"rendered":"#’Stepped’ approach to exercise can help with arthritic knees"},"content":{"rendered":"

“#’Stepped’ app<\/a>roach to exercise can help with arthritic knees<\/strong>”<\/p>\n

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\"'Stepped'<\/figure>\n<\/div>\n<\/div>\n

(HealthDay)\u2014Millions of Americans suffer from the pain of arthritic knees. But an innovative exercise regimen may help relieve discomfort and improve knee function, a new study finds.\n <\/p>\n

The program is called STEP-KOA (short for stepped exercise program for patients with knee osteoarthritis). It starts with gentle exercises at home and, if needed, moves to phone consultation and in-person physical therapy.<\/p>\n

“STEP-KOA could be an efficient way to deliver exercise and physical therapy services for people with knee osteoarthritis, since it reserves the more resource-intensive steps for people who do not make improvements earlier,” said lead author Kelli Allen. She’s a research health scientist at the Durham VA Medical Center in North Carolina.<\/p>\n

“This could be important in health systems that are trying to maximize resources or when there is limited access to physical therapy,” Allen said.<\/p>\n

For the study, researchers from the Veterans Affairs Health Care System randomly assigned more than 300 patients with painful knee osteoarthritis to either STEP-KOA or arthritis education. Osteoarthritis is the most common form of arthritis in the knee. It is a degenerative, “wear-and-tear” type of arthritis.<\/p>\n

STEP-KOA starts with an internet-based exercise program. If it is not effective, the patient moves to step two, which included twice-monthly coaching phone calls for three months.<\/p>\n

If pain still does not improve, the patient moves to step three, which included in-person physical therapy.<\/p>\n

Participants in the arthritis education group were mailed educational materials every two weeks.<\/p>\n

After nine months, 65% of patients in STEP-KOA progressed to step two, and 35% went on to step three.<\/p>\n

Compared to participants who received education only, the stepped-care group had greater improvement in pain and function, the researchers reported.<\/p>\n

This strategy could lower health care costs and tailor programs to patients’ needs, the study authors said.<\/p>\n

However, a prominent orthopedic surgeon called this approach backwards. <\/p>\n

It should start instead with physical therapy and move on to patients doing exercises on their own, said Dr. Jeffrey Schildhorn of Lenox Hill Hospital in New York City.<\/p>\n

“It seemed like this study was designed for a style of medicine that I think very few of us would appreciate,” Schildhorn said. “It was almost like you’re preparing for a future where there are limited resources, and you try to do everything remotely, and you put the responsibility on the patient,” he added.<\/p>\n

Schildhorn noted that 90 patients dropped out of the program, and only 10% remained at step one throughout the study.<\/p>\n

Because each patient’s knee damage and perception of pain is unique, an effective program must be individually designed, he said.<\/p>\n

“I think that it’s imperative that people who have mild to moderate disease try to do whatever they can on their own, with or without in-person physical therapy,” Schildhorn said.<\/p>\n

The key is to keep the joint moving with gentle exercise. A multimodal approach that includes periodic check-ins with a therapist, being shown in person how to do the movements with follow-up by phone or video chat is a viable approach, he said.<\/p>\n

But patients need to do their exercises at home every day, Schildhorn emphasized.<\/p>\n

“Someone who goes to physical therapy three times a week probably doesn’t do as well as someone who goes three times a week and practices on their own. The majority of the value comes with daily in-home, stretching exercises,” Schildhorn said. “If you go to physical therapy two times a week, then do nothing the other five days, there’s zero value there.”<\/p>\n

The report was published online Dec. 29 in the Annals of Internal Medicine<\/i>.\n <\/p>\n\n

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Exercise may not provide benefit over physical therapy after knee replacement\n <\/p><\/div>\n

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\n More information:<\/strong>
\n Learn more about knee osteoarthritis from the American Academy of Orthopaedic Surgeons<\/a>.<\/p><\/div>\n

\n Copyright \u00a9 2020 HealthDay<\/a>. All rights reserved.<\/p>\n

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