Musculoskeletal, Surgery, Inflammation and Recovery case studies

Exercise App brings benefits in six weeks

Knee osteoarthritis causes the cartilage in the knee to grow thin. This means patients’ knees don’t move smoothly, becoming painful and stiff.

Severe osteoarthritis makes the knee unstable and painful.

Current treatment options for osteoarthritis pain include - for very severe cases surgery - meaning total knee replacement.

Less invasive options recommended by NICE are:

• Education (learning how to cope with the disease)
• Weight loss. This is a good idea for overweight people to reduce also other diseases but is difficult to achieve
• Over-the-counter pain killers such as Paracetamol or Ibuprofen, which can have some side effects, and are not very effective
• Prescription pain killers such as opioids, which may have serious side effects and induce addiction
• Exercises to strengthen muscles and relieve pain, which are safe and effective

The problem with exercise programmes is motivating people to keep performing the exercises several times per week. 

The Nottingham BRC has used an exercise intervention initially developed in Sweden in face-to-face visits in >70,000 people. This was then adapted into an app, with videos taking the patient through the exercises step-by-step and helping the patient track progress.

Recruitment started in October 2018 and the research was published in the JAMA Open Network.

We found that substantial improvements are seen within six weeks of exercise delivered via a smartphone or tablet computer.

People in the exercise group were able to get up from a chair and walk faster, increased the number of “chair stands” they could do in 30 seconds, and then increased the strength of their leg muscles.

Digital health exercise

• Is an effective way to significantly reduce/manage pain in people with knee osteoarthritis
• Increases the muscle strength of hamstrings and quadriceps
• Improves functional abilities (such as walking, getting up from a chair)
• Improves the self-satisfaction of patients with their daily living activities
• The improvement in functional ability is correlated with increased leg muscle strength

Our researchers are currently exploring how to deliver the same type of exercise for people recovering from surgery.