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Title:Model telerehabilitacije za bolnike z osteoartrozo kolenskega sklepa
Authors:ID Kotnik, Petra (Author)
ID Hussein, Mohsen (Mentor) More about this mentor... New window
Files:.pdf 4423$$Petra_Kotnik_doktorska_disertacija-A.pdf (3,10 MB)
MD5: 82B40230559E5438D0F0D4777EFEF5C6
 
Language:Slovenian
Work type:Doctoral dissertation
Organization:UNM FZV - University of Novo mesto - Faculty of Health Sciences
Abstract:Uvod: Osteoartroza (OA) kolenskega sklepa je vodilni vzrok kronične bolečine, funkcionalne prizadetosti in zmanjšane kakovosti življenja. Kljub uveljavitvi terapevtske vadbe kot temelja konzervativnega zdravljenja ostaja dostop do kakovostne rehabilitacije omejen. Namen raziskave je bil celostno ovrednotiti učinkovitost telerehabilitacije pri bolnikih z OA kolenskega sklepa z vidika gibljivosti, bolečine, funkcije kolenskega sklepa, telesne dejavnosti, kakovosti življenja in zadovoljstva bolnikov. Metode: V enocentrično randomizirano kontrolirano preskušanje je bilo vključenih 118 bolnikov z radiološko potrjeno OA kolenskega sklepa (stopnja 1–3 po Kellgren-Lawrenceovi lestvici; povprečna starost 63 let; 67 % žensk), randomiziranih v telerehabilitacijsko (TS; n = 57) ali kontrolno skupino z vadbenimi navodili v brošuri (KS; n = 61). Obe skupini sta izvajali enak 12-tedenski strukturiran vadbeni program, ki se je razlikoval izključno po načinu posredovanja. Izidi so bili merjeni pred intervencijo in po njej z goniometrijo, lestvicama NRS in WOMAC, vprašalnikoma IPAQ in SF-12 ter lastnima instrumentoma zadovoljstva in funkcionalne samoocene. Statistična analiza je temeljila na mešani analizi variance. Rezultati: Interakcijski učinki skupina × čas niso bili statistično značilni pri gibljivosti, bolečini ali kakovosti življenja. Obe skupini sta dosegli klinično relevantna znotraj skupinska izboljšanja gibljivosti (TS: +7,45°; KS: +8,03°) in zmanjšanja bolečine (TS: -1,75; KS: -1,98 točke NRS). V TS so bila ugotovljena statistično visoko značilna izboljšanja na vseh dimenzijah WOMAC (p < 0,001; ?p2 = 0,195 do 0,410), skupni WOMAC v KS pa ni dosegel statistično zanesljivega izboljšanja. Raven telesne dejavnosti se ni statistično značilno spremenila. Funkcionalna samoocena je statistično značilno napovedala zadovoljstvo (R2 = 0,307; p < 0,001), pri čemer sta bila okorelost in gibljivost najmočnejša napovednika. Razprava: Odsotnost medskupinskih razlik potrjuje funkcionalno ekvivalenco obeh pristopov in kaže, da je primarni mediator terapevtskega učinka strukturirana vadba in ne njen tehnološki okvir. TS je dosegla statistično zanesljivo izboljšanje skupnega WOMAC in telesne komponente kakovosti življenja, KS pa ne, kar nakazuje klinično relevantno prednost telerehabilitacije pri celovitem funkcionalnem napredku. Odsotnost spremembe telesne dejavnosti kaže, da vadba brez vedenjskih komponent ne zadostuje za preoblikovanje splošnih gibalnih vzorcev.
Keywords:osteoartroza kolenskega sklepa, telerehabilitacija, terapevtska vadba, randomizirano kontrolirano preskušanje, funkcionalna rehabilitacija, kakovost življenja, zadovoljstvo bolnikov
Year of publishing:2026
PID:20.500.12556/ReVIS-14029 New window
Publication date in ReVIS:12.06.2026
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Downloads:0
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Secondary language

Language:English
Title:Model of telerehabilitation for patients with knee osteoarthritis
Abstract:Introduction: Knee osteoarthritis (OA) is a leading cause of chronic pain, functional impairment, and reduced quality of life. Despite the establishment of therapeutic exercise as the cornerstone of conservative treatment, access to high-quality rehabilitation remains limited. The aim of the study was to comprehensively evaluate the effectiveness of telerehabilitation in patients with knee OA in terms of mobility, pain, knee joint function, physical activity, quality of life, and patient satisfaction. Methods: A single-center randomized controlled trial included 118 patients with radiologically confirmed knee osteoarthritis (grade 1–3 according to the Kellgren–Lawrence scale; mean age 63 years; 67% women), randomized into a telerehabilitation group (TG; n = 57) or a control group receiving exercise instructions via brochure (CG; n = 61). Both groups performed the same 12-week structured exercise program, differing only in the mode of delivery. Outcomes were measured before and after the intervention using goniometry, the NRS and WOMAC scales, the IPAQ and SF-12 questionnaires, and proprietary instruments for satisfaction and functional self-assessment. Statistical analysis was based on mixed analysis of variance. Results: Interaction effects (group × time) were not statistically significant for mobility, pain, or quality of life. Both groups achieved clinically relevant within-group improvements in mobility (TG: +7.45°; CG: +8.03°) and reductions in pain (TG: −1.75; CG: −1.98 NRS points). In the TG, statistically highly significant improvements were observed across all WOMAC dimensions (p < 0.001; ηp² = 0.195 to 0.410), whereas the total WOMAC score in the CG did not reach statistically significant improvement. The level of physical activity did not change significantly. Functional self-assessment was a statistically significant predictor of satisfaction (R² = 0.307; p < 0.001), with stiffness and mobility being the strongest predictors. Discussion: The absence of between-group differences confirms the functional equivalence of both approaches and indicates that the primary mediator of therapeutic effect is structured exercise rather than its technological delivery. The TG achieved statistically significant improvement in total WOMAC score and the physical component of quality of life, whereas the CG did not, suggesting a clinically relevant advantage of telerehabilitation in overall functional improvement. The lack of change in physical activity indicates that exercise alone, without behavioral components, is insufficient to modify general movement patterns.
Keywords:knee osteoarthritis, telerehabilitation, therapeutic exercise, randomized controlled trial, functional rehabilitation, quality of life, patient satisfaction


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