Effect of Egoscue Corrective Exercise Prescription on Acute and Short-term Chronic Knee and Hip Pain
Condition: Chronic Pain
MeSH terms: Chronic Pain
Study type: Interventional

Summary: 
      The primary purpose of this experimental study was to determine the acute effect following
      one treatment and the short-term effect after a two-week program of Egoscue corrective
      exercises on chronic knee and hip pain.
    

Detailed description: 
      Participants for this study were recruited from the university community via email
      announcements and flyers. Participants were adults with chronic knee and/or hip pain. Chronic
      pain was defined as pain on most days of the week for at least 12 weeks. Individuals were
      excluded from the study if they (a) had undergone a knee or hip surgery or had sustained a
      knee or hip injury in the past 12 months, (b) were currently receiving any form of pain
      treatment such as physiotherapy, chiropractic, intraarticular injections, or prescription
      pain medications, (c) exhibited a severe lack of mobility, (d) reported an initial pain level
      < 3 cm on the Visual Analog Scale (VAS) scale, (e) were pregnant, or (f) were unable to
      understand English. Individuals were not excluded from participation if they were taking
      non-prescription drugs such as nonsteroidal anti-inflammatory drugs, although they were
      required to refrain from taking any pain medication during the 12 hours preceding the first,
      and subsequent assessments. A power analysis using a power level of 80% and alpha set at 0.05
      indicated a sample size of 40 participants (20 in the control group and 20 in the exercise
      group). A large effect size (0.80) was assumed because this has been reported in the
      literature26 for differences in Western Ontario and McMaster Universities Arthritis Index
      (WOMAC) scores following an at-home exercise program. Forty-two eligible participants were
      originally recruited.

      All participants completed a pre-participation questionnaire that included questions about
      age, gender, injuries, pain medication use, and previous or planned total hip and/or knee
      arthroplasty. Participants completed two versions of the VAS for knee and/or hip pain: one
      for pain at rest and one for pain during movement. If participants had pain in multiple
      joints, they were told to record their overall level of pain. Participants were told to
      indicate their "usual pain" over the past seven days. Participants needed to have a VAS pain
      score of at least 3 cm (either at rest or during movement) in order to participate in the
      study. Participants also completed the WOMAC at the time of the visit. Participants' body
      mass was measured to the nearest 0.1 kg and height to the nearest 0.5 cm using a digital
      scale and a stadiometer, respectively.

      Egoscue Method protocol was followed and a postural alignment specialist trained in postural
      evaluation conducted an assessment. To reduce possible inter-rater error, the same researcher
      conducted all postural evaluations. An individualized exercise program (E-cise menu) was
      generated using the ePeteTM software (version 4.4.3) based on the noted postural deviations.
      To ensure that all participants were prescribed the same volume of exercise, the E-cise menus
      were adjusted by adding or removing exercises so the time required to complete the exercises
      was approximately 45 minutes.

      Participants in the exercise group were led through their complete E-cise menu by the
      researcher to ensure competency on the exercises. Participants in the control group did not
      perform any exercises for 45 minutes. Following the first exercise session or 45 minutes of
      rest, participants completed the VAS again for their current knee and/or hip pain at rest and
      with movement.

      All participants were given logs (one for each day of the week), which they were to fill out
      every evening before retiring to bed. These logs contained questions about their compliance
      to the E-cise menu (for those in the exercise group), pain medication use, and a VAS for pain
      at rest and during movement. Participants in the control group were instructed to maintain
      their current lifestyle for the two week duration of the study and a return visit was
      scheduled one week later. Participants in the exercise group were scheduled for a return
      visit the following day so that E-cises could be observed for competency and any adjustments
      could be made to the E-cise menu if participants were experiencing pain during an E-cise.
      Participants in the exercise group were instructed to complete their E-cise menu at home on
      at least five days of the week, but preferably every day, for the next two weeks.

      All participants were assessed and evaluated on all variables previously mentioned at the end
      of week number 1 and again at the end of the study after week number 2. Participants in the
      control group were given a personalized E-cise menu, along with instructions, at this time.
    

Intervention name(s): Corrective exercise
Intervention type(s): Other
Intervention description(s): Participants were assigned to either the exercise group, which performed Egoscue corrective exercises for two weeks, or the control group, which did not receive any treatment for two weeks.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment