Digital therapy for osteoarthritis tops other methods, says study

A meta-analysis of published studies looking at web-, app- or telehealth-based therapy for osteoarthritis has concluded that they outperform standard approaches to care.

The study – published in the journal Osteoarthritis and Cartilage – focused on patients with osteoarthritis of the hip or knee, and compared the digitally-delivered exercises to standard approaches such as in-person physiotherapy, other forms of care, waitlisting and patient education.

Medical guidance for knee and hip osteoarthritis is generally that first-line treatment should include disease information and a long-term exercise programme aimed to limiting pain and preserving joint function.

However, this is often underused, in part because of access to therapists, and in recent years more emphasis has been given to remote exercise therapy using digital delivery that can be carried out at the patient's home.

The analysis covered 10 studies out of a total found of more than 7,000, and involved 3,402 participants with hip and knee osteoarthritis.

It found that the digitally-delivered exercises performed better than the comparison approach on pain measures, both within three months and beyond six months of follow-up.

"Improvements in pain symptoms is an important outcome as this can be associated with improvement in function, health, and returning to activities of daily living," write the authors of the study.

"There is robust evidence to suggest an increased effect within the first three months of implementation across all modes of delivery - video, web or app-based," they add.

The researchers also point out that pain is the main driver for osteoarthritis patients to seek out additional healthcare, so improving pain management in the community could help to reduce the burden of the disease on health services.

"Given that exercise delivered digitally is not inferior to usual care, alternate modes of delivery of exercises, or education only, the uptake of digital care on the future of management in [osteoarthritis] must be considered," they conclude.

The research was presented earlier this month at the 2022 OARSI World Congress on Osteoarthritis in Berlin, Germany.