• Chris Kennedy

Telehealth Physiotherapy for Knee Osteoarthritis Treatment

Knee Osteoarthritis Overview

Osteoarthritis is what most people are referring to when they say arthritis. Although there are over 100 different kinds of arthritis, osteoarthritis is by far the most common. There are many things you can do to help with your osteoarthritis pain and the outlook for most people is very positive. With the right approach there is every chance you will be able to keep doing all the things that are important to you. In this article we’ll focus on knee osteoarthritis.

What is Osteoarthritis?

Osteoarthritis (OA) is a joint problem that can cause persistent joint pain and difficulties with daily activities. Osteoarthritis affects the whole joint including cartilage, bone, ligaments and muscles.


Who is at risk for developing Knee Osteoarthritis?

Osteoarthritis is more common in older people, but can affect younger people as well. Some things that increase the risk of developing knee osteoarthritis include being overweight, sport injuries, and prolonged kneeling for work. However, for many people the cause is not known. It doesn’t matter if the cause of osteoarthritis is unknown, as the cause does not influence the management plan.

How is it diagnosed?

Your doctor will usually diagnose you with knee osteoarthritis if you:

  • Are aged 45 or over

  • Have knee pain when you are active that has lasted more than 3 months

  • Have either no morning knee stiffness or morning stiffness that lasts no longer than 30 minutes

  • Have no history suggestive of another health problem (your doctor will check for other health problems).

  • X-rays are not required to diagnose knee osteoarthritis or to decide on the best treatments for you. This is because x-ray results are poorly related to how much pain, stiffness or disability you may experience, and x-rays do not tell us which treatments will be most beneficial for you.


What will happen over time?

For most people, knee osteoarthritis will be stable with occasional flare-ups from time to time. While a flare will make you feel worse for a little while, the pain will usually settle down again in time. Most people’s knee osteoarthritis will not become severe enough to need a joint replacement. In fact, your pain may improve over time. Taking control of your knee osteoarthritis and learning ways to manage your pain are really important. Finding a team of trusted health professionals, and others who can provide support and understanding will help you manage as your needs change over time.


Common osteoarthritis beliefs that are all FALSE:

  • Pain comes from wearing down of the cartilage

  • Osteoarthritis always gets worse over time

  • Exercise will further damage the knee joint

  • There is nothing to be done for knee pain

  • Joint replacement surgery is always needed


Putting it all together

Pain in knee osteoarthritis is complex. Changes to the knee tissues, your mood, anxiety and stress levels, poor sleep or fatigue or sometimes just focussing too much on the pain can all affect your experience of pain. Pain can make you avoid activity and can affect your mood and sleep. But inactivity leads to muscle weakness, weight gain, feelings of joint instability and can make your mood and sleep problems worse. These factors can affect each other to create a cycle that makes your pain feel even worse. Staying active, losing weight (if you need to) and strengthening your muscles can help with the pain and can stop the cycle of decline, as well as improve your overall health.

How InReach Online Physio can help:

We’re here to help develop a treatment plan that works for you - which can successfully be done online! There has been quite a bit of research in the area of telehealth physiotherapy (also known as - virtual physiotherapy, online physiotherapy, telerehabiliation) for knee osteoarthritis, chronic knee pain, and even for post-operative knee replacement. In general, the research results indicate that it works! Here’s an overview of the research.

  • For persons with chronic knee pain, an internet-delivered, physiotherapist-prescribed 3 month exercise and pain-coping skills training resulted in clinically meaningful improvements in pain and function that are sustained for at least 6 months (2).

  • A 6-week exercise program provided by telephone to persons with knee pain or osteoarthritis was as beneficial as in-clinic exercise for 50 patients with knee osteoarthritis in Nigeria (3).

  • An exercise program delivered via group-based video-conferencing improved clinical outcomes in an uncontrolled study of 22 older patients with knee pain in Hong Kong (4).

  • Finally, there is limited research on the use of telehealth in patients after knee joint replacement surgery but the results indicate that participants were highly satisfied with the physiotherapy component and valued the development of a bond with the therapist while maintaining privacy and personal space (5).

Taken as a whole, the research indicates that telehealth physiotherapy is an effective, safe, acceptable, and viable alternative to traditional treatment delivery. Such a mode of delivery greatly improves access to these effective treatments, which is the mission of InReach Online Physio. If you have questions about the topic of knee osteoarthritis or would like to get started on a treatment plan please get in touch with us today.


Chris Kennedy, Registered Physiotherapist

InReachPhysio


References:

1. Physiotherapy Exercise and physical Activity for Knee osteoarthritis, University of Melbourne. (2020). Physiotherapy Exercise and physical Activity for Knee osteoarthritis – Osteoarthritis Information. Retrieved from https://healthsciences.unimelb.edu.au/departments/physiotherapy/about-us/chesm/news-and-events/peak-training-program

2. Internet-Delivered Exercise and Pain-Coping Skills Training for Chronic Knee Pain. (2017). Annals of Internal Medicine166(7). doi: 10.7326/p17-9031

3. Odole, A. C., & Ojo, O. D. (2014). Is Telephysiotherapy an Option for Improved Quality of Life in Patients with Osteoarthritis of the Knee? International Journal of Telemedicine and Applications2014, 1–9. doi: 10.1155/2014/903816

4. Wong, Y. K., Hui, E., & Woo, J. (2005). A community-based exercise programme for older persons with knee pain using telemedicine. Journal of Telemedicine and Telecare11(6), 310–315. doi: 10.1258/1357633054893346

5. Kairy, D., Tousignant, M., Leclerc, N., Côté, A.-M., Levasseur, M., & Researchers, T. (2013). The Patient’s Perspective of in-Home Telerehabilitation Physiotherapy Services Following Total Knee Arthroplasty. International Journal of Environmental Research and Public Health10(9), 3998–4011. doi: 10.3390/ijerph10093998

INREACH PHYSIO

InReach Physio is operating out of Vancouver, BC, Canada and currently providing telephysio, telerehabilitation and online physio (virtual physio) services in British Columbia.

We are seeking registered PT's in provinces outside of British Columbia to expand our online physio service. Apply with CV/Resume to the email below.

 

Email: inreachphysio@gmail.com

Tel: 604-809-8832

             

                       

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