The effects of a physical therapy service based on patient-centered approach on adherence to home programs in persons with knee pain$

Abstract

Knee pain is a common symptom reported in older adults, contributing to the decreased physical function and quality of life. Exercises have been suggested to be an effective intervention for persons with knee pain. However, a high rate of non-adherence with home-based exercises has been reported, resulting in a decline in the benefits of exercise over time. Patient adherence could be affected by a number of factors; one of them is patients’ participation in their care. This study was aimed to evaluate the effects of a physical therapy service based on patient-centered approach on adherence to home programs and pain in persons with knee pain. An 8-week study was conducted to community-dwelling persons with knee pain who were allocated to either patient-centered (PC, n = 21, mean age 67.1 ± 8.2 years) or therapist-centered (TC, n = 22, mean age 62.2 ± 7.9 years) physical therapy services. Participants’ adherence (frequency and duration) to home programs was interviewed and recorded every 2 weeks. Their severity of knee pain was evaluated on a numeric rating scale (0-10) at pre- and post-program study. The results showed no significant difference in the adherence to home programs between the PC and TC groups. During the 8-week study, the PC and TC participants conducted their home programs about 4-6 days a week. The time they took performing the programs on each day was about 35-50 minutes per day. For the self-reported severity of knee pain, the paired t-test revealed a significant decrease in pain after 8 weeks of both PC and TC participants (mean[SD] -2.0[2.3], P = 0.001; and -1.7[2.6], P = 0.005, respectively) without a significant difference between groups. It is suggested that community dwellers with knee pain could benefit from both patient- and therapist-centered physical therapy services. Future studies should be considered to explore the long-term effects of these physical service approaches.