Home Exercise Programs

A single moderate quality article suggests that exercise combined with education is superior to general advice alone to improve the average pain levels, stiffness at its worst, and the global rating of change scores in individuals with ankle osteoarthritis.14 The exercise plus education group participated in group physiotherapy for 6 weeks, then transitioned to a home exercise program for the remainder of the study duration. Outcome differences between groups peaked at the 8-week time frame and were less pronounced at the 12-week follow-up.

Limitations: 

• Recommendation is based upon a single, moderate quality study 
• The study is a feasibility study with small sample size 
• The participants in the study who were provided with a home exercise program had first received 6 weeks of supervised group physiotherapy, which may have impacted the results as it pertains to the effectiveness of the home program.  

Benefits & Harms: 

• Possible benefits include relief of pain and stiffness with improved global rating of change for individuals who perform a prescribed home exercise program following supervised physical therapy.
• Potential harm is largely minimal and primarily associated with the effects of exercise, such as fatigue and muscle soreness.

Outcome Importance: 

• Individuals with ankle osteoarthritis may benefit from group education and exercise, including a home exercise program. Inclusion of a home exercise program following discharge from a supervised group exercise program may assist in maintaining or further improving the benefits.

 Cost Effectiveness/Resource Utilization: 

• Use of a home exercise program could potentially mitigate costs associated with more invasive interventions. 
• Performance of a home-based exercise program is a cost-effective intervention as minimal equipment is needed. 
• Use of a home exercise program may reduce the number of physical therapy visits needed, thus minimizing costs. 

Feasibility: 

• Use of a home exercise program is very feasible for individuals with ankle osteoarthritis to perform. Little if any equipment is necessary for completion of the program and the time commitment is minimal. 

Future Research: 

• Conduct randomized controlled trials examining the effectiveness of home exercise programs for symptom relief and quality of life improvement for individuals with ankle osteoarthritis. 
• Assess optimal dosing of home exercise programs for individuals with ankle osteoarthritis.  
• Evaluate effectiveness of specific exercises to be included within a home exercise program for individuals with ankle osteoarthritis.