Patient-reported knee osteoarthritis problems and rehabilitation goals: A qualitative study.

Abstract

Background Knee osteoarthritis manifests as a myriad of signs and symptoms, driving people to seek rehabilitation. It is unclear which features of osteoarthritis patients view as most problematic and what their specific rehabilitation goals are. Objective To explore what individuals with painful osteoarthritis identify as the worst aspect of their knee problems, along with their 3-month rehabilitation goals. Methods Qualitative study with content analysis. Data from 387 participants in a randomized controlled trial, comparing in-person and telerehabilitation physiotherapy, were analyzed. All participants had chronic knee pain consistent with a clinical diagnosis of knee osteoarthritis. Pre-consultation surveys included open-text responses to two questions: 1) worst aspect of knee osteoarthritis and 2) 3-month functional rehabilitation goals. Responses were analyzed inductively, and knee problems were deductively mapped to the International Classification of Functioning, Disability, and Health framework. Results Participants identified wide-ranging knee osteoarthritis problems, including impairments (e.g., pain and sleep problems), activity limitations (e.g., walking and using stairs), and participation restrictions (e.g., running, spending time with family, and gardening). Three-month functional rehabilitation goals included: 1) walk more and with fewer restrictions, 2) become more physically active and/or return to physical activity, 3) improve performance of activities of daily living, 4) improve general health and well-being, and 5) increase participation in meaningful activities. Conclusions People with knee osteoarthritis vary widely in the knee problems they consider most problematic and the rehabilitation goals they prioritize, which may be centered on high-level physical activities. Based on our findings, clinicians and researchers should consider using outcome measures that capture individualized goals.