Description
Background
Recently, Platelet-Rich Plasma (PRP) therapy has become to be used for Knee Osteoarthritis (KOA), and a consensus was published by ESSKA ORBIT. Patient-Reported Outcomes Measures (PROMs) are often used to determine the efficacy of treatment for KOA, but some problems have been pointed out, such as the fact that PROMs are easily influenced by the condition of the patient on the day of the outpatient visit. However, recent advances in wearable devices have made it possible to objectively quantify and track the amount of daily activity. Although the evaluation of daily activity volume may lead to a new way to determine the effectiveness of treatment, there have been no reports comparing the relationship between daily activity volume and changes in conventional PROMs.
Subjects and Methods
29 patients (age 65.6 ± 9.3 years (mean ± SD), male/female: 7/22) who received three intra-articular doses of leukocyte-poor PRP every 4 weeks for KOA were included in the study. Various PROMs (VAS, KOOS) were obtained before and six months after the administration of PRP, and the amount of activity (low-intensity activity time (LPA), moderate to vigorous physical activity time(MVPA), total activity time (TPA), number of steps) was evaluated by wearing the iAide 2 (Tokai Inc.) during the two weeks before and six months after the administration of PRP.
Results
The correlation between baseline PROMs and activity level showed that the lower the VAS and the higher the KOOS(A) and KOOS(Q), the longer the MVPA, and the higher the KOOS(A), the longer the number of steps. By using the Omeract-Oarsi responder criteria, 16 patients in Responder group and 13 patients in Non-Responder group. All PROMs were significantly improved only in Responder group (VAS:53.2→20.7,KOOS(A)74.6→88.6,(Q)39.1→63.8, p<0.05), but all activity measures were not significantly changed in both groups. (Responder group/ Non-responder group: LPA; 55.8→37.5 (min/day)/ 63.6→45.0 (min/day), MVPA;35.8→40.7 (min/day)/ 50.2→59.8 (min/day), TPA; 91.6→78.2 (min/day)/ 111.5→107.2 (min/day), number of steps; 5109.8→4415.9 (step/day)/ 6370.9→6417.0 (step/day)) (Figure)
Discussion
In this study, the better the baseline PROMs, the higher the activity level, but there was no significant improvement in activity level in either Responder or Non-Responder groups. This results suggests the need for the development of treatment methods and evaluation tools to intervention to improve patient activity level in order to extend healthy life expectancy in the future.
