Effectiveness of a blended care intervention in physiotherapy with exercise and education for patients with hip or knee osteoarthritis (SmArt-E): A multicentre pragmatic randomized controlled trial
Authors' conclusion
SmArt-E did not demonstrate superior effectiveness over usual care in mild hip and/or knee OA. Both groups improved over time, with slightly more favourable but clinically inconclusive outcomes in the IG.
Study context
- Population
- Patients with physician-diagnosed hip and/or knee osteoarthritis (OA) aged ≥50 (hip) or ≥38 years (knee), 27 physiotherapy practices in Germanymean age 64±8 years
- Participants
- 330 patients
- Comparison
- 12-month smartphone-assisted physiotherapy vs usual care
- SmArt-En = 166
- Usual caren = 164reference
- Primary endpoint
- Co-primary: pain (NRS, 0-10) and physical function (HOOS/KOOS-ADL, 0-100)
- Follow-up
- Twelve months
Methodological detailsmulticentre, pragmatic, parallel-group
- Multicentre
- Pragmatic
- Parallel-group
Primary result
As reported in the abstract
Pain (NRS, 0-10), between-group difference
No significant between-group difference in pain
−0.36
95% CI −0.84 to 0.12p=0.14
Secondary outcomes
Co-primary: physical function (HOOS/KOOS-ADL, 0-100), between-group difference · twelve months
- No significant between-group difference in physical function
- 2.66 (95% CI: −0.46 to 5.77; p=0.09)
13 secondary outcomes (OARSI domains) · three and twelve months
- Significant differences favouring the IG for several domains; effect sizes small and unlikely to be clinically meaningful
Original publication
Effectiveness of a blended care intervention in physiotherapy with exercise and education for patients with hip or knee osteoarthritis (SmArt-E): A multicentre pragmatic randomized controlled trial. Osteoarthritis Cartilage. Published 29 June 2026. doi:10.
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