Exercise is effective for older people with knee pain

Published on 01 January 2008
Source: Arthritis Today

A man on an exercise bike

Exerciseself-management and active coping strategies are effective in relieving knee pain in older adults, a new Arthritis Research UK study has shown.

Results of the ESCAPE-knee pain (Enabling Self-management and Coping with Arthritic Knee Pain through Exercise) trial published in Arthritis Care and Research showed that, compared to the usual GP care, 6 weeks of simple exercises produced meaningful improvements in function for up to 6 months for the typical patient suffering with knee pain.

There were also improvements in pain, general quality of life, anxiety and depression in the 5-year Arthritis Research UK-funded study.

Professor Mike HurleyPrincipal investigator of ESCAPE-knee pain, Mike Hurley, professor of physiotherapy at King’s College, London, said: “From these results a vast and increasing number of people may not have to continue to suffer a very debilitating condition that is largely dismissed as the inevitable, untreatable consequence of old age. People do not have to suffer it and put up with it, they can learn to live with it, and help themselves.”

A total of 418 people aged over 50 who had knee pain for more than 6 months were recruited from 54 inner city GP practices in south London. They were randomised into different groups to compare the effectiveness of a rehabilitation programme offering exercise, self-management and active coping strategies compared to “usual GP care.”

Those in the exercise group took part in 12 weekly half-hour sessions individually or in groups. Exercises aimed to build up the quadriceps muscle which supports the knee and improves strength, endurance, flexibility, balance, coordination and cardiovascular fitness, using an exercise bike and wobble boards.

Those who took part in the exercise arms of the trial had better functioning for up to six months after completing the programme compared to those in the usual care group.

Professor Hurley commented: “The people taking part in ESCAPE were unusual in that they were the typical person who knocks on their GPs surgery door looking for help; participants were socio-economically and ethnically mixed and we had no upper age limit. They also often had co-morbidities such as diabetes and heart problems; again these problems are often screened out in other trials.”

As the prevalence of chronic ill health increased, so did the need for safe, effective, low-tech affordable interventions promoting self-management that could be delivered to large numbers of individuals.

“The study also evaluated the costs of the intervention, which were shown to be relatively small and more cost-effective than usual care, so decision-makers can see that they can easily afford it,” said Professor Hurley.

The results of the study are being used to support the forthcoming NICE guidelines for the management of osteoarthritis.

Read the story of Mary, a participant in the trial.