A Randomized Trial of the CARE -KOA’s© Efficacy on Ultrasound Measured Femoral Cartilage Thickness and Quality of Life in Knee Osteoarthritis Patients
Author(s)
Tina Thomas Dias, MPT1, Charu Eapen, PhD1, Atmananda S Hegde, MS2.
1Department of Physiotherapy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Mangalore, India, 2Department of Orthopedics, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Mangalore, India.
1Department of Physiotherapy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Mangalore, India, 2Department of Orthopedics, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Mangalore, India.
OBJECTIVES: Knee osteoarthritis (KOA) is a debilitating musculoskeletal condition that results in chronic pain, functional impairment, and reduced quality of life. While conventional rehabilitation focuses on the knee musculature, recent evidence emphasizes the significance of proximal muscle groups in modulating joint biomechanics and disease progression. However, the effect of core-focused intervention on joint structure and patient-reported outcomes assessed by ultrasonography remains insufficiently explored. This randomized trial evaluated the efficacy of a 12-week Core Activation and Rehabilitation Exercises for Knee Osteoarthritis (CARE-KOA©) program alongside standard knee rehabilitation, compared to routine knee-focused rehabilitation, and examined the changes in ultrasound-measured femoral cartilage thickness and quality of life.
METHODS: 100 patients with clinically diagnosed KOA were randomized to either the CARE-KOA© intervention or control group. Assessment was conducted at baseline and 12 weeks. Femoral cartilage thickness was measured using ultrasonography. Quality of life was evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Lower Extremity Functional Scale (LEFS). Statistical analysis included between-group comparisons and repeated measures ANOVA.
RESULTS: At 12 weeks, the CARE-KOA© group demonstrated significantly greater improvement in femoral cartilage thickness, particularly in the medial femur (0.25 ± 0.06 cm vs. 0.22 ± 0.04 cm, p=0.008) and the lateral femur (0.27 ± 0.11 cm vs. 0.23 ± 0.05 cm, p=0.037). The intervention group also achieved superior gains in KOOS Pain (82.11 ± 9.47 vs. 76.23 ± 9.97, p=0.005), KOOS Quality of Life (75.48 ± 8.73 vs. 65.47 ± 12.46, p<0.001), and LEFS (78.85 ± 10.07 vs. 64.45 ± 18.00, p<0.001) compared to the control group. Effect sizes for key outcomes were large (Cohen’s d > 1.0).
CONCLUSIONS: The trial demonstrates that integrating the CARE-KOA© program yields improvements in the femoral cartilage thickness and enhances the quality of life of individuals diagnosed with KOA. These findings advocate for the integration of targeted core strengthening into KOA management to achieve superior structural and functional benefits, which may help slow disease progression.
METHODS: 100 patients with clinically diagnosed KOA were randomized to either the CARE-KOA© intervention or control group. Assessment was conducted at baseline and 12 weeks. Femoral cartilage thickness was measured using ultrasonography. Quality of life was evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Lower Extremity Functional Scale (LEFS). Statistical analysis included between-group comparisons and repeated measures ANOVA.
RESULTS: At 12 weeks, the CARE-KOA© group demonstrated significantly greater improvement in femoral cartilage thickness, particularly in the medial femur (0.25 ± 0.06 cm vs. 0.22 ± 0.04 cm, p=0.008) and the lateral femur (0.27 ± 0.11 cm vs. 0.23 ± 0.05 cm, p=0.037). The intervention group also achieved superior gains in KOOS Pain (82.11 ± 9.47 vs. 76.23 ± 9.97, p=0.005), KOOS Quality of Life (75.48 ± 8.73 vs. 65.47 ± 12.46, p<0.001), and LEFS (78.85 ± 10.07 vs. 64.45 ± 18.00, p<0.001) compared to the control group. Effect sizes for key outcomes were large (Cohen’s d > 1.0).
CONCLUSIONS: The trial demonstrates that integrating the CARE-KOA© program yields improvements in the femoral cartilage thickness and enhances the quality of life of individuals diagnosed with KOA. These findings advocate for the integration of targeted core strengthening into KOA management to achieve superior structural and functional benefits, which may help slow disease progression.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
PCR8
Topic
Epidemiology & Public Health, Medical Technologies, Patient-Centered Research
Topic Subcategory
Adherence, Persistence, & Compliance, Patient-reported Outcomes & Quality of Life Outcomes
Disease
Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal)