Synchronous Versus Asynchronous Telephysiotherapy for GLA:D Exercise in Primary Knee Osteoarthritis: A Pilot Study

Yohanes Deo Fau; Angria Pradita; Sartoyo; Ahmad Abdillah Iqbal; Ester Popy Bove

doi:10.24843/

Authors

Yohanes Deo Fau Department of Physiotherapy, Faculty of Health Science, Institute of Science and Health Technology dr. Soepraoen Hospital, Malang, Indonesia Author
Angria Pradita Department of Physiotherapy, Faculty of Health Science, Institute of Science and Health Technology dr. Soepraoen Hospital, Malang, Indonesia Author
Sartoyo Department of Physiotherapy, Faculty of Health Science, Institute of Science and Health Technology dr. Soepraoen Hospital, Malang, Indonesia Author
Ahmad Abdillah Iqbal Department of Physiotherapy, Faculty of Health Science, Institute of Science and Health Technology dr. Soepraoen Hospital, Malang, Indonesia Author
Ester Popy Bove Department of Physiotherapy, Faculty of Health Science, Institute of Science and Health Technology dr. Soepraoen Hospital, Malang, Indonesia Author

DOI:

https://doi.org/10.24843/

Keywords:

OSTEOARTHRITIS, Knee, Exercise Therapy, Telemedicine, Patient Outcome Assessment

Abstract

Background: Knee osteoarthritis (OA) causes pain, stiffness, and functional limitations. GLA:D Exercise can be delivered through telephysiotherapy, but direct comparisons between synchronous and asynchronous delivery remain limited.
Objective: To compare changes in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores following GLA:D Exercise delivered through synchronous versus asynchronous telephysiotherapy in women with primary knee OA.
Methods: This pilot quasi-experimental pretest-posttest two-group study included 30 women, with 15 participants per group. Both groups received the same GLA:D Exercise program three times weekly for 8 weeks, with 30 minutes of planned exercise per session. The synchronous group received approximately 15 minutes of real-time physiotherapist supervision through Zoom, whereas the asynchronous group followed exercise videos through WhatsApp with family assistance. WOMAC was assessed before and after the intervention.
Results: WOMAC scores decreased from 45.20 ± 8.90 to 40.33 ± 9.39 in the asynchronous group (p=0.001) and from 39.27 ± 8.36 to 27.40 ± 8.14 in the synchronous group (p<0.001). Mean reductions were 4.87 ± 4.45 and 11.87 ± 6.65 points, respectively. The between-group difference in change was 7.00 points (95% CI, 2.77 to 11.24; p=0.002), with a large standardized effect (Hedges’ g=1.20; approximate 95% CI, 0.44 to 1.97).
Conclusion: Both delivery modes were associated with lower WOMAC scores after 8 weeks, with a larger observed reduction in the synchronous group. Given the nonrandomized design and small sample, this difference should not be interpreted as evidence of causal superiority.