@Article{info:doi/10.2196/71057,
author="Wang, Zi-Ru
and Wang, Yunqi
and Duan, Shuning
and Chen, Xier
and Ni, Guoxin",
title="Effects of an e-Learning Program (Physiotherapy Exercise and Physical Activity for Knee Osteoarthritis [PEAK]) on Chinese Physical Therapists' Confidence and Knowledge: Randomized Controlled Trial",
journal="J Med Internet Res",
year="2025",
month="Apr",
day="18",
volume="27",
pages="e71057",
keywords="osteoarthritis; telehealth; exercise therapy; e-learning; physiotherapist; Knee Osteoarthritis Knowledge Scale",
abstract="Background: Knee osteoarthritis (OA) presents a significant burden in China due to its high prevalence, aging population, and rising obesity rates. Despite clinical guidelines recommending evidence-based care, limited practitioner training and inadequate telehealth integration hinder effective OA management. Objective: The aim of this study was to evaluate the effectiveness of an e-learning program in improving the confidence and knowledge of Chinese physical therapists in managing knee OA and to explore their perceptions of the program. Methods: This was a randomized controlled trial with 2 parallel arms involving 81 rehabilitation practitioners from 18 Chinese provinces. The intervention group completed a 4-week web-based training program (Physiotherapy Exercise and Physical Activity for Knee Osteoarthritis [PEAK]-Chinese), while the control group received no training. The primary outcome was self-reported confidence in OA management (11-point scale). Secondary outcomes included knowledge (Chinese Knee Osteoarthritis Knowledge Scale [KOAKS]) and likelihood of clinical application of core OA treatments. Process measures and semistructured interviews captured participants' training perceptions. Quantitative data were analyzed using regression models, 2-sided t tests, and descriptive statistics, while thematic analysis was performed on the interview data of 10 participants. Results: A total of 80 participants completed the outcome measures at 4 weeks. The intervention group demonstrated significant improvements in confidence compared to the control group, including managing OA with exercise-based programs (adjusted mean difference=3.27, 95{\%} CI 2.72-3.81), prescribing exercise (adjusted mean difference=3.13, 95{\%} CI 2.55-3.72), and delivering telehealth (adjusted mean difference=4.41, 95{\%} CI 3.77-5.05). KOAKS scores also improved significantly (mean change=9.46); however, certain belief bias related to OA concepts and the use of scans remained unchanged (25/41, 61{\%} and 27/41, 66{\%}, respectively). Approximately 73{\%} (30/41) of the intervention participants rated the course as extremely useful. Interviews emphasized the need for cultural adaptation and practical telehealth training with real-life scenarios to enhance program applicability. Conclusions: The PEAK program improved Chinese practitioners' confidence and knowledge in managing knee OA, underscoring e-learning's potential to support evidence-based OA care in China. To optimize future implementations, further research strategies could include enhancing cultural relevance, addressing misconceptions, and incorporating practical, real-world training. Trial Registration: Chinese Clinical Trial Register ChiCTR2400091007; https://www.chictr.org.cn/showproj.html?proj=239680 ",
issn="1438-8871",
doi="10.2196/71057",
url="https://www.jmir.org/2025/1/e71057",
url="https://doi.org/10.2196/71057"
}