Functional Outcomes and Predictors of Response in Knee Osteoarthritis Following a Home-Based Structured Exercise Program

Background Structured exercise is a key conservative approach in managing knee osteoarthritis, but the effectiveness of home-based programs and predictors of individual response remain less explored. The study aimed to assess the effectiveness of a structured home-based exercise program on functional outcomes in knee osteoarthritis (OA) and identify predictors of successful outcome. Methods This prospective longitudinal study included 30 patients with knee OA who followed an eight-week home-based exercise regimen involving warm-up, strengthening, stretching, and neuromuscular control exercises. Functional outcomes were assessed using six-minute walk test (6MWT) and Knee Injury and Osteoarthritis Outcome Score (KOOS) at baseline, four weeks, and eight weeks. Baseline imaging included radiographs and three-phase bone scan with single-photon emission computed tomography-computed tomography (SPECT/CT). A successful clinical outcome was defined as Patient Global Impression of Change score <3 at eight weeks. Results Participants (age: 50±7 years; 25 women) showed significant improvement in 6MWT (P<0.001) and total KOOS (P=0.025), particularly in the sports and recreation subdomain (P=0.022). Sixty percent (18/30) of patients achieved a successful outcome. Early KOOS improvement at four weeks was the only independent predictor of successful clinical outcome (odds ratio (OR): 1.115; P=0.047). Imaging parameters, including SPECT/CT, did not predict outcome. Conclusion Home-based exercise significantly improved function in knee OA. Early changes in KOOS scores predicted outcome, while imaging findings were not predictive.