The relationship between radiological OA severity or body weight and outcomes following a structured education and exercise therapy program (GLA:D®) for people with knee osteoarthritis

Abstract

Background: Clinicians may presume people with higher bodyweight or greater OA severity do not respond to exercise therapy for knee osteoarthritis (OA), but few studies have examined this. Objective: To examine the relationship between radiographical OA severity or bodyweight and pain and functional outcomes following a structured education and exercise therapy program (Good Life with OsteoArthritis from Denmark: GLA:D (R)). Methods: 33 participants with knee OA were assessed at baseline and week 8 following GLA:D (R). Outcomes were pain (Visual analogue scale (VAS) 0-100), Knee Injury and Osteoarthritis Outcome Score-12 (KOOS-12 total), 40 m-fast-paced walk and 30-s chair stand. Multilevel models were used to define the severity of OA in medial, lateral and patellofemoral compartments using the Kellgren-Lawrence (KL) system and to examine the relationship between compartment severity, bodyweight and outcomes. Results: No meaningful relationships between bodyweight and response to GLA:D (R) were found for any outcome measures. Greater medial OA compartment severity was related to less improvement in pain, KOOS-12 and chair stand repetitions. However, all levels of lateral compartment severity had similar improvements, and greater patellofemoral compartment severity was related to more improvement for KOOS-12 and pain. Conclusion: Bodyweight may have little influence on a person's response to a structured education and exercise therapy program. While people with greater medial compartment severity were less likely to improve following the program, OA severity in the PF and lateral compartments was not a barrier to improvement.