Managing Osteoarthritis of the Knee Evaluating the OA Knee Class: A 6 week programme of education and exercise Sam Dawson MSc BSc MSCP Senior Physiotherapist Wrexham Maelor Hospital

What is the problem 4.71 million in the UK sought treatment for OA Knee 2.36 million ‘working age’ people have sought treatment for OA Knee Becoming more problematic 4.7 million in 2010, to 5.4 million in 2020, reaching 6.4 million by 2035 Including obesity impact - 4.7 million in 2010, to 6.5 million by 2020, reaching 8.3 million by 2035 A recent study shows that of people with or at risk of Osteoarthritis only 13% meet physical activity guidelines with 45% rated as inactive Secondary to population growth and aging of the population this is expected to rise

What does the current evidence say? (NICE 2014) Informing and educating patients to enhance self management Increasing activity and exercise including local muscle strengthening and general aerobic fitness Interventions to achieve weight loss in those classified as overweight or obese

What is the OA Knee Class? 6 week self management programme Patients with diagnosed OA Knee Exercise (45mins) and education (15mins) With an exit strategy/aim of continued exercise or self management Education sessions covered include: What is Osteoarthritis of the Knee? Pacing Activity Diet and Weight Management Managing and Coping with Flare ups Pain Management Exercise and the Exercise Referral Scheme

Description of the Study Physiotherapy Department at Wrexham Maelor Hospital Data collected in 2013/2014 - 60 patients 6 week programme consisting of an individualised exercise programme and education sessions Outcome measure (Oxford Knee score) and satisfaction survey – baseline, after completion of programme

Patient Satisfaction Results 97% of patients felt more able to cope with their knee pain after attending 87% of patients rated the service as excellent with the other 13% rating it as good 100% of patients felt that the clinicians treating them knew enough about their condition 58/60 patients = 97%

Patient Comments “The team were friendly and approachable, exercises chosen really helped me ease the pain” “They helped me control my pain, helped me understand what the problem was and how to help myself” “The physio’s were excellent, targeting exercises to your activity level and encouraging you to progress steadily, it is an excellent and worthwhile service”

Oxford Knee Score The Oxford Knee Score 0 (indicating severe problems with arthritis) 48 (indicating no problems with arthritis) The average score on attendance was 24 and on discharge was 30. This indicates an average change of 6 points which is a clinically significant change especially in a relatively short period of time! Average score AFTER attending OA Knee Class Average score BEFORE attending OA Knee Class

Future Proposals Results indicate: Development of Course Reduced demand on orthopaedics Reduced demand on physiotherapy services Reduced demand on primary care services Reduced health care costs Improved general health and well being Development of Course Development of education talks in line with current evidence Involvement of wider MDT to deliver specific talks Inclusion of Injection