Temporal Patterns of Pain and Function Recovery During Online and Offline Group Rehabilitation for Knee Osteoarthritis: Secondary Analysis of a Randomized Controlled Trial

Abstract

Background: Rehabilitation is effective for knee osteoarthritis, but the timing of pain and functional improvement within short-term programs remains unclear

Objective: This secondary analysis of a randomized controlled trial compared early (0–3 weeks) and later (3–6 weeks) changes in pain and function within online and offline group rehabilitation

Methods: One hundred sixty patients with knee osteoarthritis were randomized to online (n=76) or offline (n=84) group exercise for six weeks. Pain (VAS) and function (WOMAC) were measured at baseline, 3 weeks, and 6 weeks, and analyzed using piecewise linear mixed-effects models.

Results: Pain declined steadily across both phases in online (−0.92 vs −0.91 points/week; p=0.88) and offline (−1.12 vs −1.02 points/week; p=0.13) groups. Functional improvement was greater in the later phase, significantly so in the online group (−8.71 vs −6.69 points/week; p<0.001).

Conclusion: Pain relief occurs evenly across 6 weeks, while functional gains are more pronounced during weeks 3–6, highlighting the need to complete the full program to maximize recovery