Tailored exercise management versus usual care for people aged 80 years or older with hip/knee osteoarthritis and comorbidities (TEMPO): multicentre feasibility randomised controlled trial in England

Journal article

ObjectiveTo assess the feasibility of conducting a definitive randomised controlled trial (RCT) to test the clinical and cost-effectiveness of a tailored exercise intervention compared with usual care for people aged 80 years and older with hip and/or knee osteoarthritis (OA) and comorbidities.DesignTwo-arm, parallel-design, multicentre, pragmatic, feasibility RCT.SettingFour National Health Service outpatient physiotherapy services across England.ParticipantsAdults aged 80 years and over with clinical hip and/or knee OA and ≥1 comorbidity.InterventionsParticipants were randomised 1:1 via a central web-based system to be offered: (1) a 12-week tailored exercise programme or (2) usual care. Participants and outcome assessors were not blinded to treatment allocation. FEASIBILITY OBJECTIVES: (1) Ability to screen and recruit participants; (2) retention of participants at 14-week follow-up; (3) intervention fidelity (proportion of participants who received ≥4 intervention sessions as per protocol) and (4) participant engagement (assessed by home exercise adherence).ResultsBetween 12 May 2022 and 26 January 2023, 133 potential participants were screened, of whom 94 were eligible. The main reasons for ineligibility were symptoms not consistent with hip or knee OA (10/39, 25.6%) or already having had a physiotherapy appointment (8/39, 20.5%). 51 of 94 (54%) eligible participants were recruited. Participants had a mean age of 84 years (SD 3.5), 31 (60.8%) were female and 96.1% reported their ethnicity as White British (n=49/51). 45 of 51 participants (88%) provided outcome data at the 14-week follow-up time point. Four or more intervention sessions were attended by 13/25 (52%) participants. Home exercise log completion declined over time: 6/23 participants (26.1%) returned completed exercise logs for all 12 weeks. The median number of days home exercises were recorded each week was 5 (range 0-7).ConclusionsThis study demonstrated that a definitive trial would be feasible. Before proceeding, modifications to ensure recruitment of a diverse population and intervention fidelity should be addressed.Trial registration numberISRCTN75983430.

Authors: Nicolson, PJA; Holden, MA; Marian, I; Saeedi, E; Williamson, E

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: BMJ Publishing Group
• Journal: BMJ Open
• Volume: 15
• Issue: 9
• Pages: e104813
• Publication date: 2025-09-22
• Acceptance date: 2025-08-28
• DOI: 10.1136/bmjopen-2025-104813
• EISSN: 2044-6055
• ISSN: 2044-6055
• Pmid: 40983572
• Language: English
• Keywords: Male; Osteoarthritis, Hip; Aged, 80 and over; Female; Exercise Therapy; Frail Elderly; Comorbidity; Rehabilitation Medicine; Humans; Feasibility Studies; England; Exercise; Osteoarthritis, Knee; Cost-Benefit Analysis