Telehealth-delivered group-based exercise therapy and education for knee osteoarthritis: A non-inferiority randomised clinical trial disrupted by COVID-19.
Christian J Barton, Marcella Pazzinatto, Zuzana Perraton et al.
✦ AI-curated · Sources linked
In 30 seconds
This pre-registered, two-arm non-inferiority randomised clinical trial compared telehealth with in-person delivery of a group exercise therapy and education program for people with knee osteoarthritis. Recruitment stopped early because of COVID-19 restrictions, with 44 participants enrolled rather than the planned 110. The lower limit of the 95% confidence interval for the between-group difference in KOOS4 was above the −10-point non-inferiority threshold at 3 months (6, 95% CI −2 to 15) and 12 months (0, 95% CI −9 to 9). The findings suggest knee-related burden may not differ between delivery modes.
Key findings
- KOOS4 at 3 months showed a mean difference of 6 (95% CI −2 to 15), with the lower confidence limit above the −10-point non-inferiority threshold.
- At 12 months, the KOOS4 mean difference was 0 (95% CI −9 to 9), also meeting the stated non-inferiority criterion.
- Worst pain reduction was greater with telehealth at 3 months than with in-person delivery (mean difference 16.5, 95% CI 0.8 to 32.2).
- Follow-up data were available for 43 participants at 3 months, 40 at 12 months and 29 at 24 months.
Why it matters
Group exercise and education are options for managing knee osteoarthritis, but attending in-person programs can be difficult. These results provide preliminary evidence that telehealth delivery may achieve similar knee-related burden outcomes to in-person delivery, potentially supporting access when attendance is a barrier. The early recruitment stop and limited participant numbers mean the findings should be interpreted cautiously.
What to keep in mind
Recruitment stopped because of COVID-19 restrictions, leaving 44 participants versus the planned 110; follow-up data declined to 29 participants by 24 months.