Absence of improvement with exercise in some patients with knee osteoarthritis: a qualitative study of responders and nonresponders

Key Points

1. Better understanding factors that can potentially influence response to exercise interventions in patients with knee OA can help guide clinicians to identify patients at risk of nonresponse to exercise and consider strategies to optimize outcomes.

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BACKGROUND & OBJECTIVE

Although exercise has shown moderate effects on pain and physical function in patients with knee osteoarthritis (OA), it is unclear why some patients with knee OA respond to exercise-based interventions while others do not (1). Qualitative studies can shed light on factors that patients perceive to influence response to exercise-based treatment and in turn, facilitate earlier identification of individuals at risk of nonresponse.

Therefore, the objective of this qualitative study was to compare the perceptions of patients about why they did, or did not, respond to a physical therapist–supported exercise and physical activity program.

It is unclear why some patients with knee OA respond to exercise-based interventions while others do not.

A separate set of less evocative exercises (“rescue program”) can be provided to encourage the patient to continue exercising during a flare-up.

METHODS

This was a qualitative study within a randomized controlled trial. Twenty-six participants with knee OA were sampled according to response (n = 12 responders, 14 nonresponders based on changes in pain and physical function at 3 and 9 months after

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