Chronic arthritis has been the subject of a number of self-management studies. Hurley and coworkers compared the effectiveness of a rehabilitation program integrating exercise, self-management, and active coping strategies (Enabling Self-management and Coping with Arthritic Knee Pain through Exercise [ESCAPE-knee pain]) with usual primary care in improving functioning in persons with chronic knee pain. The criteria for participation was that the patients were 50 years or older and had reported knee pain for over 6 months. Fifty-four inner-city practices were randomized to continue usual primary care (i.e., whatever intervention a participant's primary care physician deemed appropriate), usual primary care plus the rehabilitation program delivered to individual participants, or usual primary care plus the rehabilitation program delivered to groups of participants. The primary outcome was self-reported functioning six months after completing rehabilitation. A total of 418 participants were recruited; 76 dropped out due to adverse events. Rehabilitated participants had better functioning than participants who received usual primary care. Improvements were similar whether participants received individual rehabilitation or group rehabilitation.

VALUE OF STUDY TO READER: The ESCAPE-knee pain program provided a safe, relatively brief intervention for chronic knee pain that is equally effective whether delivered to individuals or groups of participants. As noted in an earlier entry, the approach was also cost-effective. A strength of the study is that a large number of patient participated in the trial; the weakness of the study is the short-term follow-up (6 months).

MV Hurley et al. Clinical effectiveness of a rehabilitation program integrating exercise, self-management, and active coping strategies for chronic knee pain: A cluster randomized trial. Arthritis and Rheumatology, 2007;57:1211-1219.