Back to Journals » Clinical Interventions in Aging » Volume 9

Development of comorbidity-adapted exercise protocols for patients with knee osteoarthritis

Authors de Rooij M, van der Leeden M, Avezaat E, Häkkinen A, Klaver R, Maas T, Peter WF, Roorda LD, Lems WF, Dekker J

Received 9 October 2013

Accepted for publication 29 November 2013

Published 14 May 2014 Volume 2014:9 Pages 829—842

DOI https://doi.org/10.2147/CIA.S55705

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Mariëtte de Rooij,1 Marike van der Leeden,1,2 Ellis Avezaat,3 Arja Häkkinen,4 Rob Klaver,1 Tjieu Maas,5 Wilfred F Peter,1 Leo D Roorda,1 Willem F Lems,1,6 Joost Dekker1,7

1Amsterdam Rehabilitation Research Center, Reade, Amsterdam, the Netherlands; 2VU University Medical Center Department of Rehabilitation Medicine, Amsterdam, the Netherlands; 3Sint Lucas Andreas Hospital, Department of Physical Therapy, Amsterdam, the Netherlands; 4Department of Health Sciences, University of Jyväskylä and Jyväskylä Central Hospital, Jyväskylä, Finland; 5HAN University, Institute of Health, GGM, Institute for Sports and Exercise Studies, Nijmegen, the Netherlands; 6VU University Medical Center, Department of Rheumatology, Amsterdam, the Netherlands; 7VU University Medical Center, Department of Psychiatry and Department of Rehabilitation Medicine, EMGO Institute, Amsterdam, the Netherlands

Background: Exercise therapy is generally recommended for patients with osteoarthritis (OA) of the knee. Comorbidity, which is highly prevalent in OA, may interfere with exercise therapy. To date, there is no evidence-based protocol for the treatment of patients with knee OA and comorbidity. Special protocols adapted to the comorbidity may facilitate the application of exercise therapy in patients with knee OA and one or more comorbidities.
Purpose: The purpose of this study was to develop comorbidity-adapted exercise protocols for patients with knee OA and comorbidity.
Method: Several steps were undertaken to develop comorbidity-adapted protocols: selection of highly prevalent comorbidities in OA, a literature search to identify restrictions and contraindications for exercise therapy for the various comorbid diseases, consultation of experts on each comorbid disease, and field testing of the protocol in eleven patients with knee OA and comorbidity.
Results: Based on literature and expert opinion, comorbidity-adapted protocols were developed for highly prevalent comorbidities in OA. Field testing showed that the protocols provided guidance in clinical decision making in both the diagnostic and the treatment phase. Because of overlap, the number of exercise protocols could be reduced to three: one for physiological adaptations (coronary disease, heart failure, hypertension, diabetes type 2, chronic obstructive pulmonary diseases, obesity), one for behavioral adaptations (chronic a-specific pain, nonspecific low back pain, depression), and one for environmental adaptations (visual or hearing impairments). Evaluation of patient outcome after treatment showed significant (P<0.05) and clinically relevant improvements in activity limitations and pain.
Conclusion: Comorbidity-adapted exercise protocols for patients with knee OA were developed, providing guidance in clinical reasoning with regard to diagnostics and treatment. To evaluate the effectiveness of treatment in line with our protocols, a randomized clinical trial should be performed.

Keywords: knee osteoarthritis, exercise therapy, comorbidity, rehabilitation, arthritis, coexisting disease

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]

 

Readers of this article also read:

Green synthesis of water-soluble nontoxic polymeric nanocomposites containing silver nanoparticles

Prozorova GF, Pozdnyakov AS, Kuznetsova NP, Korzhova SA, Emel’yanov AI, Ermakova TG, Fadeeva TV, Sosedova LM

International Journal of Nanomedicine 2014, 9:1883-1889

Published Date: 16 April 2014

Methacrylic-based nanogels for the pH-sensitive delivery of 5-Fluorouracil in the colon

Ashwanikumar N, Kumar NA, Nair SA, Kumar GS

International Journal of Nanomedicine 2012, 7:5769-5779

Published Date: 15 November 2012

A novel preparation method for silicone oil nanoemulsions and its application for coating hair with silicone

Hu Z, Liao M, Chen Y, Cai Y, Meng L, Liu Y, Lv N, Liu Z, Yuan W

International Journal of Nanomedicine 2012, 7:5719-5724

Published Date: 12 November 2012

Cross-linked acrylic hydrogel for the controlled delivery of hydrophobic drugs in cancer therapy

Deepa G, Thulasidasan AK, Anto RJ, Pillai JJ, Kumar GS

International Journal of Nanomedicine 2012, 7:4077-4088

Published Date: 27 July 2012

Crystallization after intravitreal ganciclovir injection

Pitipol Choopong, Nattaporn Tesavibul, Nattawut Rodanant

Clinical Ophthalmology 2010, 4:709-711

Published Date: 14 July 2010