Thesis (Ph.D.) - Cairo University - Faculty of Physical Therapy - Department of Musculoskeletal Disorder

Background: Osteoarthritis (OA) is the most common degenerative joint disease, which causes disability and substantial socioeconomic burden. Exercises have been proven to be the most effective conservative treatment for patients with OA, however, scientific evidence regarding exercise prescription is still lacking. The development of clinical prediction rules to identify patients who are most likely to benefit from exercise may help solving this dilemma. Purpose: This study investigated whether body mass index (BMI), ageor functional ability at baseline can predict patients{u2019} response to a selected exercise program. Patients and Methods: Fifty-six patients, aged 35 to 65 years, completed an exercise program consisting of open kinetic chain strengthening and passive stretching exercises. The program was given for 3 sessions per week, 45 minutes per session, for 6 weeks.At baseline and post treatment, pain severity was assessed using the numerical pain rating scale, whereas functional ability was assessed by step test (ST), time up and go (TUG) test and 50 feet time walk (50 FTW) test. After completing the program, global rate of change score of greater than 4 was used to categorize patients{u2019} response as successful and unsuccessful. Results: Thirty-eight patients (68%) had successful response to the intervention. Logistic regression showed that BMI,age and 50 FTW test were the only significant predictors. Based on the results, patients with BMI less than 35 kg/m2, age less than 52 years and 50 FTW test speed of less than 26 sec are 68% to 89% more likely to benefit from the exercise program. Conclusions: Clinicians should consider the described strengthening and stretching exercise program for patients who fulfill the age, BMI and walking speed criteria. The validity of these predictors should be investigated for other exercise programs

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