Patel Kushang V, Hoffman Elise V, Phelan Elizabeth A, Gell Nancy M
Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington, USA.
Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA.
ACR Open Rheumatol. 2022 Aug;4(8):735-744. doi: 10.1002/acr2.11452. Epub 2022 Jun 10.
EnhanceFitness (EF) is an evidence-based exercise program recommended for management of osteoarthritis (OA). However, access to EF is limited in rural areas. Accordingly, we evaluated the feasibility and acceptability of remotely delivered EF (tele-EF) in rural, community-dwelling older adults with symptomatic knee OA.
A single-arm pilot trial of tele-EF classes was conducted. Videoconferencing was used to livestream the instructor-led, 1-hour EF classes 3 days/week for 12 weeks. Outcomes were assessed at baseline and immediately post intervention.
A total of 15 of 27 potential participants (55%) were screen eligible and enrolled into the trial. Participants had a median age of 70 years (interquartile range: 67-75), and 14 (93%) were women. The median EF class attendance rate was 91% (interquartile range: 85%-94%). Knee pain, as measured by the Knee Injury and Osteoarthritis Outcome Score (KOOS), improved significantly from baseline to the 12-week end point (mean difference = -11.4 [95% confidence interval (CI): -20.9 to -2.0]; P = 0.02). In addition, participants' self-reported knee function improved significantly (mean difference in KOOS function score = -11.8 [95% CI: -18.4 to -5.2]; P < 0.01) as well as their physical capacity (mean difference in Timed Up and Go test time = 1.8 seconds [95% CI: 0.2-3.4]; P = 0.03). All participants (100%) were very satisfied with tele-EF classes, and 12 participants (86%) reported that their condition had much improved or very much improved since beginning the EF exercise program. Lastly, there were no serious adverse events.
Findings from this pilot trial indicate that tele-EF is feasible and acceptable in rural older adults with knee OA.
增强体质锻炼法（EF）是一种基于证据的运动项目，推荐用于骨关节炎（OA）的管理。然而，在农村地区，获得EF的途径有限。因此，我们评估了为有症状的膝关节OA的农村社区老年人远程提供EF（远程EF）的可行性和可接受性。
进行了一项远程EF课程的单臂试点试验。使用视频会议每周3天直播由教练指导的1小时EF课程，共12周。在基线和干预后立即评估结果。
27名潜在参与者中有15名（55%）符合筛查条件并纳入试验。参与者的中位年龄为70岁（四分位间距：67 - 75岁），14名（93%）为女性。EF课程的中位出勤率为91%（四分位间距：85% - 94%）。用膝关节损伤和骨关节炎疗效评分（KOOS）测量的膝关节疼痛从基线到12周终点有显著改善（平均差异=-11.4 [95%置信区间（CI）：-20.9至-2.0]；P = 0.02）。此外，参与者自我报告的膝关节功能有显著改善（KOOS功能评分的平均差异=-11.8 [95% CI：-18.4至-5.2]；P < 0.01）以及他们的身体能力（计时起立行走测试时间的平均差异=1.8秒[95% CI：0.2 - 3.4]；P = 0.03）。所有参与者（100%）对远程EF课程非常满意，12名参与者（86%）报告自开始EF运动项目以来他们的状况有很大改善或非常大的改善。最后，没有严重不良事件。
该试点试验的结果表明，远程EF在患有膝关节OA的农村老年人中是可行的且可接受的。
