Jessep, Sally A., Walsh, Nicola E., Ratcliffe, Julie and Hurley, Michael V. (2009) Long-term clinical benefits and costs of an integrated rehabilitation programme compared with outpatient physiotherapy for chronic knee pain. Physiotherapy, 95(2), pp. 94-102. ISSN (print) 0031-9406Full text not available from this archive.
BACKGROUND: Chronic knee pain is a major cause of disability in the elderly. Management guidelines recommend exercise and self-management interventions as effective treatments. The authors previously described a rehabilitation programme integrating exercise and self-management [Enabling Self-management and Coping with Arthritic knee Pain through Exercise (ESCAPE-knee pain)] that produced short-term improvements in pain and physical function, but sustaining these improvements is difficult. Moreover, the programme is untried in clinical environments, where it would ultimately be delivered. OBJECTIVES: To establish the feasibility of ESCAPE-knee pain and compare its clinical effectiveness and costs with outpatient physiotherapy. DESIGN: Pragmatic, randomised controlled trial. SETTING: Outpatient physiotherapy department and community centre. PARTICIPANTS: Sixty-four people with chronic knee pain. INTERVENTIONS: Outpatient physiotherapy compared with ESCAPE-knee pain. OUTCOMES: The primary outcome was physical function assessed using the Western Ontario and McMaster Universities Osteoarthritis Index. Secondary outcomes included pain, objective functional performance, anxiety, depression, exercise-related health beliefs and healthcare utilisation. All outcomes were assessed at baseline and 12 months after completing the interventions (primary endpoint). ANCOVA investigated between-group differences. RESULTS: Both groups demonstrated similar improvements in clinical outcomes. Outpatient physiotherapy cost pound 130 per person and the healthcare utilisation costs of participants over 1 year were pound 583. The ESCAPE-knee pain programme cost pound 64 per person and the healthcare utilisation costs of participants over 1 year were pound 320. CONCLUSIONS: ESCAPE-knee pain can be delivered as a community-based integrated rehabilitation programme for people with chronic knee pain. Both ESCAPE-knee pain and outpatient physiotherapy produced sustained physical and psychosocial benefits, but ESCAPE-knee pain cost less and was more cost-effective.
|Additional Information:||This work was supported by the Arthritis Research Campaign and the Physiotherapy Research Foundation [Project Number PRF/03/3].|
|Research Area:||Allied health professions and studies
Health services research
|Faculty, School or Research Centre:||Faculty of Health and Social Care Sciences|
|Depositing User:||Katrina Clifford|
|Date Deposited:||23 Nov 2010 10:30|
|Last Modified:||23 Nov 2010 10:30|
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