Award Title: Evaluation and Implementation of electronic-rehabilitation programmes for chronic knee pain in the UK
Funder: Versus Arthritis

Abstract: Background 

Frequent knee pain is estimated to affect one in four adults, limiting physical function and mobility and reducing quality of life.1-5 Osteoarthritis (OA) is the leading cause of chronic knee pain in those aged 45 years or older.6 The economic consequences of arthritis on the lives of individuals, the health service and on employment are high.7

 

There is evidence to support exercises in reducing pain and improving functioning.8,9 Education and support are also required in managing pain more effectively.10-11 Arthritis Research UK and UK government organisations recommend a public health approach by targeting physical inactivity as well as communicating the benefits of physical activity to individuals with musculoskeletal conditions.

 

Physiotherapists are key in providing exercise therapy and support to individuals to manage their knee OA. However, a challenge for the NHS is that physiotherapy services are overstretched. Challenges for patients have been in accessing physiotherapy for exercise therapy, training and education and also being motivated to continue with their rehabilitation. Therefore, it is important to develop alternative approaches to providing individual and clinic-based physiotherapy services through embracing technology and using the evidence supporting telehealth, such as Internet developed interventions.

 

Objectives

The overall aim of the study is to evaluate the feasibility and acceptability of two e-rehabilitation programmes in individuals with knee pain, one is a group Internet-delivered physiotherapist-prescribed home exercise acommpanied by Internet-interactive educational sessions, known as ‘Group E-Rehab’; and the other is a web-based home exercise programme with motivational text support system known as: ‘MyKneeExercise’.

 

Plan of Investigation

The study is designed as a feasibility study with nested qualitative study. We will build on and expand for use in the UK, e-rehabilitation programmes (developed in Australia). For the ‘Group E-Rehab’ intervention, we will train physiotherapists to deliver the Internet-delivered physiotherapist-prescribed home exercise. For the ‘MyKneeExercise’ intervention, this is home web-based and requires no physiotherapist input to deliver this e-rehabilitation programme. We will then undertake an exploratory feasibility trial involving both quantitative and qualitative data collection. Patients with knee pain who meet the inclusion criteria will be randomised to receive Group E-Rehab, MyKneeExercise, or usual care. We will test the feasibility and acceptability of these interventions; assess the potential use of the e-rehabilitation programmes by physiotherapists in primary and community care; and refine the trial procedures for a definitive RCT.

 

Exploitation of the Results

E-rehabilitation programmes have the potential to improve health services, by providing new models of service delivery enabling more patients to receive support and training to equip them to more effectively manage their chronic knee pain, reducing the burden on our overstretched physiotherapy services. Internet-delivered physiotherapist-prescribed home exercise supplemented with Internet-interactive educational sessions ‘Group E-Rehab’ and a web-based home exercise programme ‘MyKneeExercise’ have the potential for future implementation by the NHS as prescribed UK e-rehabilitation programmes.


Research Activity Codes: 6.7 PHYSICAL
Health Categories: MUSCULOSKELETAL