Videotape Instruction Vs Brochure On The Effectiveness Of Unsupervised Home Exercise Program In Patients With Knee Osteoarthritis


Optimum treatment for osteoarthritis is a combination of education, medication, weight reduction and exercise. However adherence to exercise decreases with treatment duration. This study aims to determine the effectiveness of a home exercise program in patients with knee osteoarthritis delivered through brochure or videotape in improving compliance, pain and function; and in the reduction of intake of paracetamol. Type of study: This is a single blind, randomized controlled study in a home setting. Participants: 102 participants with knee osteoarthritis were included in the study. Intervention: The participants were randomly assigned into video and brochure groups and were instructed to perform the exercises for six months. They were evaluated one month during the program and immediately after the end of the intervention. Outcome measures were pain using the Visual Analog Scale, modified Knee Outcome Survey-Activities of Daily Living Scale, 6 minute walk test, compliance and intake of paracetamol. Results: There were significant improvements in all outcome measures from baseline to one and six months in both groups. However, there was no significant difference between the mean change of all the outcome measures except for the mean change in the distance walked in the 6MWT one and six months which was significantly higher in the brochure group. Compliance to exercise and intake of paracetamol decreased from one to six months in both treatment arms but was not statistically different for both groups. Conclusion: Providing home exercise program using either video or brochure could be effective in the management of osteoarthritis.


Keywords: osteoarthritis, video exercise, brochure exercise, home exercise program



  1. Roddy E,  Zhang W,  Doherty M,  Arden NK,  Barlow J,   Birrell F etal. Evidence-based recommendations for the role of exercise in the management of osteoarthritis of the hip or knee—the MOVE consensus.  Rheumatology 2005;44:67–73.  doi:10.1093/rheumatology/keh39
  2. Hinman RS, Hunt MA, Creaby MW, Wrigley TV, McManus FJ, Bennell KL. Hip muscle weakness in individuals with medial knee osteoarthritis. Arthritis Care Res 2010;62(8):1190-3. doi: 10.1002/acr.20199
  3. Lin C, Taylor D, Zeinstra S, Maher C.  Exercise for osteoarthritis of the knee.  Phys Ther 2010: 90 (6): 839-842
  4. Guccione A, Felson  D. The effects of specific medical conditions on the functional limitations of elders in the Framingham study. Am J Public Health 1994 ;84:351-358
  5. Deyle G, Allison S, Matekel R. Physical Therapy Treatment Effectiveness for Osteoarthritis of the knee: A Randomized Comparison of Supervised Clinical Exercise and Manual Therapy Procedure Versus a Home Exercise Program.PhysTher  2005;  85 (12):1301-1317
  6. Page CJ, Hinman R, Bennel K. Physiotherapy management of knee osteoarthritis.  Int J Rheum Dis  2011 ;14(2):145-151. doi: 10.1111/j.1756-185X.2011.01612.x
  7. Van Gool  C, Penninx  B,  Kempen  G, Jack Rejeski W, Miller G, Van Eijk J et al .  Effects of Exercise Adherence on Physical Function Among Overweight Older Adults With Knee Osteoarthritis.  Arthritis & Rheumatism (Arthritis Care & Research)  2005:   53 (1):  24-32.  DOI 10.1002/art.20902.
  8.  Marks R, Allegrante J.  Chronic  Osteoarthritis and adherence to exercise:  a review of literature.  Journal of aging and physical activity   2005; 13:  434 – 460.
  9. Ettinger Jr WH, Burns R, Messier SP, Applegate W, Rejeski J, Morgan T, et al. A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST). J Am Med Assoc 1997;277:25 -31.
  10. Fransen M, McConnell S. Exercise for osteoarthritis of the knee. Cochrane Database of Systematic Reviews  2008, 4. Art. No.: CD004376. DOI: 10.1002/14651858.CD004376.pub2.
  11. Healthcare spending around the world, country by country.  The .  Downloaded November 3, 2014.
  12. Jay K, Schraefel MC, Brandt M, Andersen LL . Effect of video-based versus personalized instruction on errors during elastic tubing exercises for musculoskeletal pain: a randomized controlled trial 2014. BioMed Research International: 1-7. .
  13. Schoo A,   Morrisa M,  Bui Q .  The effects of mode of exercise instruction on compliance with a home exercise program in older adults with osteoarthritis.  Physiotherapy 2005; 91:  79–8.
  14. Ravaud P(22),  Giraudeau B,  Logeart  L, Larguier JS, Rolland D, Treve R, et al. Management of osteoarthritis (OA) with an unsupervised home based exercise programme and/or patient administered assessment tools. A cluster randomized controlled trial with a 2x2 factorial design.  Ann Rheum Dis  2004;63:703–708. doi: 10.1136/ard.2003.009803.
  15. Miller J, Stanley I, Moore K. Videotaped exercise instruction: A randomised controlled trial in musculoskeletal physiotherapy. Physiotherapy Theory and Practice. 2004 Jan 1;20(3):145-54.
  16. Strachota E, Schmidt S. Conceição  CO.  The Development and Validation of a Survey Instrument for the Evaluation of Instructional Aids 2006.  Available at:   Accessed  January 5 2012.
  17. Doak CC, Doak LG,  Root JH. Assessing suitability of materials. In Teaching patients with low literacy skills .2nd ed. Philadelphia PA: J.B. Lippincott Company; 1996.
  18. Shieh, C and Hosei, B. Printed Health Information Materials: Evaluation of Readibility and Suitability. J Community Health Nurs 2008;  25:70-90. doi: 10.1080/07370010802017083.
  19. Deyle G,  Henderson N, Matekel R,  Ryder M, Garber M,  Allison S. Effectiveness of  Manual Physical Therapy and Exercise in Osteoarthritis of the Knee. Ann Intern Med. 2000;132(3):173-181. doi:10.7326/0003-4819-132-3-200002010-00002.
  20. Altman R, Asch E, Bloch D, Bole D, Borenstein K,  Brandt K, et al.  Arthritis and Development of Criteria for the Classification and Reporting of Osteoarthritis. Arthritis Rheum. 1986 ; 29(8):1039-1049.
  21. Aguinaldo J, Suarez  CG, Yu MJ.   Modification And Translation Of The Knee Outcome Survey – Activities Of Daily Living Scale (KOS – ADLS) Into Filipino .  AdVeritatem:  Multi-disciplinary Research Journal of the UST Graduate School .March 2013; 12 (2):  281 -310.
  22. Irrgang  J.J, Snyder-Mackler  L, Wainner RS, Fu FH, Harner, CD.  Development of a patient-reported measure of function of the knee. J Bone Joint Surg Am 1988;80:1132-1145.
  23. Butland RJ, Pang J, Gross ER, Woodcock AA, Geddes DM. Two-, six-, and 12-minute walking tests in respiratory disease.  Br Med J (Clin Res Ed). 1982 May 29;284(6329):1607-1608.
  24. Bennell K , Hinman  R.  A review of the clinical evidence for exercise in osteoarthritis of the hip and knee.  J Sci  Med  Sport 2011; 14:  4–9.
  25. Jordan JL, Holden MA, Mason EEJ, Foster NE. Interventions to improve adherence to exercise for chronic musculoskeletal pain in adults.CochraneDatabase of SystematicReviews 2010:1. Art.No.:CD005956.DOI:10.1002/14651858.CD005956.pub2.
  26. Petrella, RJ. Is exercise effective treatment for osteoarthritis of the knee? Brit J  Sports Med 2000;. 34: 326-331.
  27. Bellamy N, Kirwan J, Boers M, Brooks P, Strand V, Tugwell P, et al. Recommendations for a core set of outcome measures for future phase III clinical trials in knee, hip, and hand osteoarthritis. Consensus development at OMERACT III. J Rheumatol 1997;24:799-802.
  28. Bruyère O, Cooper C, Pelletier JP, Branco J, Brandi ML, Guillemin F et al . An algorithm recommendation for the management of knee osteoarthritis in Europe and internationally: a report from a task force of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). InSeminars in arthritis and rheumatism 2014 Dec 31 (Vol. 44, No. 3, pp. 253-263). WB Saunders.
  29. E Roddy, W Zhang, M Doherty.  Aerobic walking or strengthening exercise for osteoarthritis of the knee? A systematic review.Ann Rheum Dis 2005;64:544–548. doi: 10.1136/ard.2004.028746.
  30. Atamaz FC, Durmaz B, Baydar M, Demircioglu OY, Iyiyapici A, Kuran B et al. Comparison of the efficacy of transcutaneous electrical nerve stimulation, interferential currents, and shortwave diathermy in knee osteoarthritis: a double-blind, randomized, controlled, multicenter study. Arch Phys Med Rehabil 2012;93:748-56.
  31. Steinberg AM, Donald KJ, Najman J, Walley L. Are older Australians being marginalised by technology? Veterans’ Health 1998:18–9.

Articles related to the one you are viewing

There are currently no results to show, please try again later

CC BY: Open Access Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit