Effects of In-Person and Distance Exercise Training on Outcomes of Knee Injury and Osteoarthritis among Elderly Individuals with Limited Literacy

Background: Osteoarthritis is a common chronic disease of the musculoskeletal system in older adults. Aim: This study aimed to compare the effects of in-person and distance exercise training on the outcomes of knee injury and osteoarthritis among the elderly with limited literacy. Method: In this two-group randomized clinical trial with a pretest-posttest design, 60 elderly patients with knee injuries and osteoarthritis selected from two public parks in Mashhad during 2017-2018 were assigned to two groups of In-person and Distance training. The educational content, which included two stretching and three strength exercises for knee injury and osteoarthritis, was presented to the Distance group using booklets and multimedia. In the In-person group, the exercises were trained in eight 30-minute sessions, two days a week. The Western Ontario and McMaster Universities Osteoarthritis questionnaire was completed before and two months after training the exercises. To analyze the data, Mann-Whitney U test and Wilcoxon signed-rank test were run in SPSS, version 16. Results: The mean ages of the In-person and Distance groups were 68.2±5.6 and 69.2±9.4 years, respectively. We found a significant difference in the outcomes of knee injury and osteoarthritis post-intervention between the In-person and Distance groups (13.8±14.0 vs. 5.0±2.6; P≤0.003). Implications for Practice: Both methods could affect the outcomes of knee osteoarthritis. The in-person method was superior to distance training. These exercises are recommended as safe and cost-effective methods that could be included in health promotion programs targeting older adults.