Digitally treating osteoarthritis through clinical, evidence-based programs can be more effective at reducing pain and improving physical function than routine self-managed care, according to research from JAMA Network Open.

Researchers from the University of Nottingham conducted a randomized control trial comparing traditional care with the digital intervention from Joint Academy to find differences in outcomes for knee osteoarthritis.

Joint Academy is an online treatment program that connects patients with a licensed physical therapist who guides them through daily personalized exercises and answers any user questions. The platform tracks progress from week to week so the program can be modified to fit the patient’s needs.

TOP-LINE DATA

After six weeks of intervention, patients using the digital treatment reported a 41% pain reduction, compared to a 6% pain reduction in the control group.

The study notes that the pain reduction from the treatment group was statistically significant, while the pain scores reported in the control group were not.

“We already knew that digital first-line treatment substantially improves symptoms of osteoarthritis at a significantly lower cost than face-to-face care,” said Leif Dahlberg, the chief medical officer at Joint Academy, in a statement. “This study firmly establishes how effective digital treatment actually is in relation to traditional self-management care.”

In addition to examining pain reduction, the researchers conducted a series of physical function tests, including the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the 30-second sit-to-stand test, the Timed Up-and-Go (TUG) test, the Arthritis Research UK Musculoskeletal Health Questionnaire (MSK-HQ), and maximum voluntary contraction of quadriceps and hamstring muscles, as well as quantitative sensory testing between baseline and six weeks.

At the six-week check-in, the intervention group improved significantly more than the control group for the WOMAC test, the 30-second sit-to-stand test, the TUG test and hamstring strength. There were no statistically significant group differences for the other tests, the researcher said in the study.

The researchers suggest that these findings indicate that digital treatments could reduce the osteoarthritis burden for both health systems and patients.

“The results of the study really show how much can be gained by treating chronic knee pain digitally, and this will help reduce the burden on the healthcare system, especially when we are going through the COVID-19 pandemic where services are already stretched,” said Sameer Akram Gohir, a physical therapist and researcher for the study, in a statement.

“We hope this study allows health policymakers to consider the potential in digital alternatives when it comes to treating knee arthritis.”

METHODS

The trial was conducted from October 2018 to March 2020. It included 105 participants age 45 or more with a diagnosis of knee osteoarthritis. The study group was 67% female and the average age was 66.7 years old.

Both study groups relied on self-management programs. The intervention group received treatment through the Joint Academy, while the control group continued their usual care program developed by their healthcare provider.

Because the study was partially conducted during the COVID-19 pandemic, 27 participants did not attend the follow-up visit. However, this loss was less than the 12% expected loss of participants, the researchers said in the study.

THE LARGER TREND

Osteoarthritis is the most common form of arthritis, affecting more than 32.5 million adults in the U.S., according to the Centers for Disease Control and Prevention.

Since there isn’t a cure for osteoarthritis, doctors typically treat it with a combination of therapies that can include increasing physical activity, weight loss, physical therapy, medications and if all else fails, surgery.

To help arthritis patients manage their chronic condition, several digital health companies have released treatment platforms. Earlier this year, U.K.-based digital health company Ampersand Health released My Arthritis DTx for patients to self-manage their condition. Last June, SidekickHealth partnered with Pfizer to launch an app that helps patients with diseases such as rheumatoid arthritis manage their conditions from home.

Outside of this research, Joint Academy raised $23 million in Series B funding last September to help it expand into the U.S.