osteoarthrities home management study presentation

1. DESERTATION
PRESENTATION
PRESENTED BY
RESHMA
COMMUNITY HEALTH NURSING

2. STATEMENT OF PROBLEM
“A study to evaluate the effectiveness of home based exercise intervention on
osteoarthritis among old age people in selected community area Bhiwani.”

3. OBJECTIVES OF THE STUDY
1.To assess the level of joint pain among old age people with osteoarthritis
before home based exercise intervention in experimental and control group.
2.To evaluate the effectiveness of home based exercise intervention on level of
joint pain among old age people with osteoarthritis in experimental group.
3.To compare the post test score of joint pain among old age people with
osteoarthritis between experimental group and control group.
4.To find out the association between posttest level of joint pain among old age
people with osteoarthritis and their selected demographic variables.

4. INTRODUCTION
Aging is the natural process. In the words of Seneca -“Old age is an incurable disease”. According
to Sir James Sterling Ross - “You do not heal old age. You protect it; you promote it; you extend it”.
With the growing aging population and increasing prevalence of obesity, the number of individuals
with knee OA is likely to increase in coming years, increasing the burden of the disease and putting
pressure in the physiotherapy services and exercise care providers.
Therefore, there is a need to develop home-based, low-cost, time-efficient exercise interventions
targeting particular muscle groups in order to increase strength, functional mobility, and physical
function in this group of individuals. In the present study, we designed a low-cost (the only material
needed was an elastic band) and time-efficient exercise intervention to be performed at home and
without supervision.
Still, benefits from such exercise interventions should not be expected without adherence to the
program. In this sense, we first attempted to show that this particular program is feasible and patients
can and are willing to perform it.

5. NEED FOR STUDY
The prevalence rate of osteoarthritis increases as age progress. The radiographic data reveals that
osteoarthritis occurs at skeletal site in the majority of people around the age of 65 years and in nearly in
everyone over 75 years of age.
Exercise proved to be effective and is highly recommended; however, patients have to participate in
exercise programs to get the benefits. The availability of excise programs is often an issue, particularly in
small towns and rural areas. Indeed, a supervised exercise program performed at gyms or rehabilitation
clinics may not be available for all patients due to several different reasons (e.g. lack of offer - rural areas
without access to a program; financial restraints; lack of time to attend supervised classes).
Thus, a home-based intervention may be a good option, as it overcomes several barriers to exercise,
namely exercise-related costs, lack of transportation, facilities/equipment, and time. Previous studies
provided encouraging results by showing that better adherence to home exercises was associated with
better patient outcomes of pain, physical function, and self-perceived effect.

6. RESEARCH HYPOTHESIS:
H1 There will be a significant difference in the level of joint pain after home
based exercise intervention among old age people with osteoarthritis in
experimental group than the control group.
H2 There will be a significant association between posttest level of joint pain
among old age people with their selected demographic variables.

7. ASSUMPTION
1. Old age people with arthritis will have joint pain.
2. Home based exercise intervention may be effective in reducing joint pain of
old age people with osteoarthritis.
3. Home based exercise intervention may be effective in reducing pain.
4. Osteoarthritis is common in women than men also it is associated with aging.

8. OUTPUT
THROUGHPUT
INPUT
Pre-test
Assessment of level of
pain using modified
extremities functional
scale in old age people
due to osteoarthritis
Demographic
variables
Age, sex, marital status,
Education, type of diet,
Family income
Home based exercise
For osteoarthritis
Sample perceive,
transform,
process, organize
and learn the
information
received from
Home based
exercise
intervention for
osteoarthritis
Negative outcome
Inadequate relief in
pain due to
osteoarthritis
Positive outcome
Adequate relief in pain
due to osteoarthritis
Fig.1 CONCEPTUAL FRAMEWORK BASED ON MODIFIED LUDWIG VON BERTALANFFY’S (1980) GENERAL
SYSTEM THEORY
Post-test
Assessment of
level of pain
using modified
extremities
functional scale
among old age
people due to
osteoarthritis
Reassessment/
reinforcement

9. REVIEW OF LITERATURE
• The literature related to this study is discussed under following headings:
• Section A: Literature related to prevalence of osteoarthritis
• Section B: Literature related to knowledge regarding osteoarthritis
• Section C: Literature related to knowledge on self care activities of
osteoarthritis
• Section D: Literature related to effect of exercise on osteoarthritis

10. TARGET POPULATION
Old age people who are living in village- Bamla and Rewari Khera, Bhiwani
SAMPLE SIZE
60 old age people (30- experimental group, 30- Control group)
SAMPLING TECHNIQUE
Convenient sampling
ANALYSIS
Descriptive and inferential statistics
TOOLS
Modified Extremities Functional Scale and Home based
exercise
Findings, summary, conclusion and
STUDY SETTING
Village- Bamla and Rewari Khera, Bhiwani
RESEARCH DESIGN
Quasi-Experimental design
RESEARCH APPROACH
Evaluative approach

11. PILOT STUDY
The pilot study was aimed to evaluate the effect of home based exercise intervention on
osteoarthritis among old age people, who are living in village- Bamla and Rewari Khera,
Bhiwani. The study was also designed to find out the feasibility of conducting the study and to
decide on the plan of statistical analysis.
After obtaining formal administrative approval from sarpanch the pilot study was
conducted at Bamla and Rewari Khera, (Bhiwani) from 13th -20th April 2022. 6 old age client
participate in pilot study. The purpose of study was explained to the group and confidentiality
of their response was assured. Simple random sampling was used to select the subjects. The
findings of pilot study revealed that it was feasible to conduct the study. The plan for data
collection remains same as per pilot study. There was full cooperation from subjects.
The plan for data collection remains the same as for the pilot study.

12. METHOD OF DATAANALYSIS
The data obtained will be analysed using the following plan of analysis:
 Organise data in Master sheet
 Frequency and percentage distribution for the analysis of demographical variables
 Mean, Median and Standard deviation of pre-test and post-test
 ‘t’ value was used to compare the effect of Home based exercise intervention of
osteoarthritis among old age client.
 Computing chi-square value (2) to determine significance of association between
selected variables and effect of Home based exercise intervention

13. ORGANIZATI ON OF FINDINGS
The data collected were tabulated and presented as follows:
• Section-A: Distribution of demographic variables of old age people with osteoarthritis in experimental and
control group.
• Section-B: Assessment of joint pain in the both experimental and control group among the selected old age
people with osteoarthritis.
• Section-C: Comparison of the effectiveness of Home based exercise intervention on level of joint pain
among old age people with osteoarthritis in experimental group
• Section-D: Comparison of pre test and post test score on level of joint pain among old age people with
osteoarthritis in control group
• Section-E: Comparison of the post test score of joint pain among old age people with osteoarthritis between
experimental group and control group.
• Section-F: Association of the post test scores of joint pain among the experimental group and control group
with their selected demographic variables.

14. SECTION-A DEMOGRAPHIC VARIABLE PROFILE
Demographic variable Experimental group N=30 Control group
N=30
Frequency Percentage Frequency Percentage
1. Age
a) >50-60 years 6 20% 10 33.33%
b) 61-70 years 15 50% 11 36.67%
c) Above 70 years 9 30% 9 30%
2. Gender
a) Male 9 30% 10 33.33%
b) Female 21 70% 20 66.67%
3. Education
a) Illiterate 9 30% 9 30%
b) Primary 10 33.33% 13 43.33%
c) High school 5 16.67% 4 13.33%
d) Senior secondary 3 10% 2 6.67%
e) Graduation and above 3 10% 2 6.67%

15. 4. Marital status
a) Married 16 53.33% 10 33.33%
b) Unmarried 2 6.67% 3 10%
c) Widow/ Widower 12 40% 17 56.67%
5. Dietary Habits
a) Vegetarian 30 100% 30 100%
b) Non-Vegetarian 0 00% 0 00%
6. Duration of pain
a) Below 2 years 9 30% 11 36.67%
c) 2-4 Years 13 43.33% 11 36.67%
d) Above 4 years 8 26.67% 8 26.66%
7. Taking drug to relieve pain
a) Yes 9 30% 5 16.67%
b) No 12 70% 25 83.33%

16. Section-B
Assessment of joint pain in the both experimental and control group among the selected old age
people with osteoarthritis.
Group Experimental group, N=30 Control group, N=30
Level of pain Pre-test Post-test Pre-test Post-test
F % F % F % F %
No Pain 0 0% 0 0% 0 0% 0 0%
Mild Pain 0 0% 18 60% 0 0% 0 0%
Moderate Pain 12 40% 12 40% 14 46.67% 17 56.67%
Severe Pain 18 60% 0 0% 16 53.33% 13 43.33%
Extreme Pain 0 0% 0 0% 0 0% 0 0%
In pre test of experimental group shows that majority 60% of old age people have severe pain of osteoarthritis and
40% have moderate pain of osteoarthritis. In post test of experimental group shows that 60% of old age people have
mild pain and 40 % old age people have moderate pain of osteoarthritis.
In pre test of control group shows that majority 53.33% of old age people have severe pain of osteoarthritis and
46.67% have moderate pain of osteoarthritis. In post test of control group shows that 56.67% of old age people have
mild pain and 43.33 % old age people have moderate pain of osteoarthritis.

17. Section-C
Comparison of the effectiveness of Home based exercise intervention on level of joint pain
among old age people with osteoarthritis in experimental group
0
20
40
60
Mean SD
52.56
7.1
25.1
6.95
Experimental Group
Pre test post test
mean and SD
Pre test
Post test
The mean score on level of joint pain among old age people with osteoarthritis in the experimental group
was 52.56 in pre test and 25.10 in post test. The paired 't' value was 16.74 which is significant at p < 0.05.
It shows that Home based exercise intervention was effective in reduction of joint pain among old age
people with osteoarthritis in the experimental group.
Hence the research hypothesis H1 is accepted.

18. Section-D
Comparison of pre test and post test score on level of joint pain among old age people with
osteoarthritis in control group
The mean score on level of joint pain among old age people with osteoarthritis
in control group was 51.63 in pre test and 52.48 in post test. The paired 't' value
was 1.31 which is not significant at P < 0.05.
0
20
40
60
Mean SD
51.63
7.71
52.48
8.05
Control group
pre and post test mean and SD
Pre test
Post test

19. Section-E
Comparison of the post test score of joint pain among old age people with osteoarthritis between
experimental group and control group.
The mean post test score in the experimental group was 25.10 with standard deviation of 6.95
whereas in the control group, the mean post test score was 52.48 with standard deviation of 8.05. The
mean difference was 27.38. The obtained independent 't' test value was 13.89 which is more than the
table value (P = 2.00) with the degree of freedom 58 at 0.05 level of significance.
Hence the Research Hypothesis (H1) is accepted and it is inferred that Home based exercises
effective in reducing the level of joint pain among the old age people with osteoarthritis in the
experimental group than in the control group.
Group Mean SD Mean Difference t- Value p- value
Experimental
group
25.10 6.95
27.38 13.89**** 2.00
Control group 52.48 8.05
*Significant at 0.05% (df=58)

20. Section-F
Association of the post test scores of joint pain among the experimental group and control group
with their selected demographic variables.
In the experimental group, with regard to age, duration of pain the chi-square value was 6.88
and 6.26. The table value at 2 degrees of freedom was 5.99 which was significant at 0.05 level.
Regarding taking drugs to relieve pain the chi-square value was 4.47. The table value at 1 degree
of freedom was 3.84 which was significant at 0.05 level. There was no significant association
between the level of joint pain among the old age people with osteoarthritis and the other
demographic variables.
In the control group, on considering the age, duration of pain the chi-square was 8.97 and
7.03. The table value at 2 degrees of freedom was 5.99 which was significant at 0.05 level. There
was no significant association between the level of joint pain among the old age people with
osteoarthritis and the other demographic variables.
Hence the hypothesis H2 was accepted

21. DISCUSSION
This chapter deals with the discussion of the findings of present study in
accordance with the objectives of the research problem. The findings of the study have
been discussed with reference to the results obtained by the investigator.
The mean score on level of joint pain among old age people with osteoarthritis in
the experimental group was 52.56 in pre test and 25.10 in post test. The paired 't' value
was 16.74 which is significant at p < 0.05. It shows that Home based exercise
intervention was effective in reduction of joint pain among old age people with
osteoarthritis in the experimental group. Hence the research hypothesis H1 is accepted.
The mean score on level of joint pain among old age people with osteoarthritis in
control group was 51.63 in pre test and 52.48 in post test. The paired 't' value was 1.31
which is not significant at P < 0.05.

22. CONCLUSION
The mean post test score in the experimental group was 25.10 with standard
deviation of 6.95 whereas in the control group, the mean post test score was
52.48 with standard deviation of 8.05. The mean difference was 27.38. The
obtained independent 't' test value was 13.89 which is more than the table value
(P = 2.00) with the degree of freedom 58 at 0.05 level of significance.
Hence the Research Hypothesis (H1) is accepted and it is inferred that Home
based exercises effective in reducing the level of joint pain among the old age
people with osteoarthritis in the experimental group than in the control group.

23. SUMMARY
The study design consisted of an evaluative approach with quasi experimental pre test and post test control group design.
The study population consisted of 60 old age people of village- Bamla and Rewari Khera, Bhiwani, a non-probability
convenient sampling technique was adopted. The tool developed and used for data collection was modified extremities
functional scale structured knowledge questionnaire, home based exercise intervention. The conceptual frame work adopted
for the study is based on general system theory Modeled by Ludwig Von Bertalanffy 1969.
The mean score on level of joint pain among old age people with osteoarthritis in the experimental group was 52.56 in
pre test and 25.10 in post test. The paired 't' value was 16.74 which is significant at p < 0.05. It shows that Home based
exercise intervention was effective in reduction of joint pain among old age people with osteoarthritis in the experimental
group. Hence the research hypothesis H1 is accepted.
The mean score on level of joint pain among old age people with osteoarthritis in control group was 51.63 in pre test
and 52.48 in post test. The paired 't' value was 1.31 which is not significant at P < 0.05.
In the experimental group, with regard to age, duration of pain the chi-square value was 6.88 and 6.26. The table value
at 2 degrees of freedom was 5.99 which was significant at 0.05 level. Regarding taking drugs to relieve pain the chi-square
value was 4.47. The table value at 1 degree of freedom was 3.84 which was significant at 0.05 level. There was no significant
association between the level of joint pain among the old age people with osteoarthritis and the other demographic variables.

24. RECOMMENDATION
• The following steps can be undertaken to strengthen the study
The study can be conducted among larger sample for the better
generalization.
The study can be conducted in different settings.
Comparison between kneading technique and other non – pharmacological
methods can be done.
Home based exercise intervention can be included in the hospital policy.

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