Tohoku J. Exp. Med., 2009, 219(2)

Physiotherapy Program through Home Visits for Community-Dwelling Elderly Japanese Women with Mild Knee Pain

ISAMU KONISHI,^1,4 NAOHITO TANABE,² NAO SEKI,³ HIROSHI SUZUKI,⁴ TARO OKAMURA,⁵ KUNIHIKO SHINODA⁶ and EMIKO HOSHINO⁷

¹Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
²Division of Health Promotion, Department of Community Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
³School of Health Sciences, Faculty of Medicine, Niigata University, Niigata, Japan
⁴Division of Public Health, Department of Infectious Disease Control and International Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
⁵Department of Rehabilitation Sciences, Faculty of Health Care Sciences, Chiba Prefectural University of Health Sciences, Chiba, Japan
⁶Faculty of Education, Niigata University, Niigata, Japan
⁷Department of Social Welfare, Niigata University of Health and Welfare, Niigata, Japan

Knee pain is extremely common among the elderly, particularly women. Hence, there is an urgent need for applicable community-based intervention models for halting the progression of knee pain and related disabilities in elderly women. We aimed to assess the efficacy of home-visit physiotherapy as a new intervention model. This non-randomized 5-month-long controlled trial enrolled elderly community-dwelling women (aged 60-83 years) with mild knee pain. The intervention consisted of two home visits by a physiotherapist, with instructions on routinely performing muscle-strengthening exercises at home and implementing simple environmental modifications when necessary. Outcome measures were assessed at baseline and 5 months later. The primary outcomes were measured as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and a newly devised seiza-style sitting score. People in Japan, especially elderly women, are accustomed to seiza-style sitting that involves kneeling on one's lower legs while resting the buttocks on the heels. The secondary outcomes included quadriceps isometric strength, knee alignment in the frontal and sagittal planes, and passive knee extension range. Forty-two subjects (20 in the intervention group and 22 in the control group) completed the study. At baseline, characteristics and the primary outcomes did not significantly differ between the 2 groups. At 5 months, the primary outcomes improved significantly in the intervention group. Estimated differences in the change from baseline for each outcome between the 2 groups were computed, adjusting for outcome variables imbalanced at baseline. Even after the adjustment, the home-visit physiotherapy regimen provides favorable improvement in the seiza-style sitting score.

keywords —— Knee pain; community; physiotherapy; Japanese elderly women; seiza-style sitting.

© 2009 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2009, 219, 91-99

Correspondence: Isamu Konishi, Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata 950-3198, Japan.

e-mail: konishi@nuhw.ac.jp