Home self-care program with physical therapy and Thai traditional medicine for older people with knee osteoarthritis in community

Abstract

Home-self care program is an alternative method of treatment for knee osteoarthritis (knee OA) patients. It suits those patients who have lived far away from the hospital because it may help save their expenses for medical care as well as trips to the hospital. Physical therapy (PT) is one of standard treatments for managing knee OA. Nowadays, Thai traditional medicine (TTM) has been commonly used in Thailandbecause it could be easily accessed and safe in most communities. The aim of study was to compare the outcome effects between a home-self care with class-based PT program and a home-self care with class-based TTM program on pain perception using visual analogue scale (VAS), knee muscle strength and range of motion (ROM) in the older people with knee OA who have lived in the Toanor and Sila villages of Khon Kaen province.  The study design was a field-based clinical trial. Fourteen participants of Toanor village received the PT (averaged age 69.8 ± 8.4 years) whereas the 17 participants of Sila village received the TTM (averaged age 67.8 ± 6.4 years).  All participants attended a class-based program (3times/week) instructed by a PT specialist, followed by a home-based (2 times/week) program for 8 weeks in the both groups.  Paired t-test and analysis of covariance (ANCOVA) statistics were used to compare the parameters within and between groups, respectively. After treatment, the VAS scores reduced in both the PT (-3.64 ± 2.31) and TTM (-4.64 ± 1.98) groups. Knee extensor strength was increased in both knees of the two groups whereas knee flexor strength was found to be increased only in both knees of the TTM group.  However, there was no statistically significant difference when compared between the two treatment groups except the knee flexor strength where the TTM group showed a significantly greater than those of the PT group (P < 0.05).  This study shows that both the home-self care with a class-based PT and TTM programs for 8 weeks could yield positive effects on knee pain and knee muscles strength.