Background It is estimated worldwide that approximately 9.6% of men and 18% of women aged over 60 years have osteoarthritis. It is known that exercise therapy for patients with hip and/or knee osteoarthritis is an effective therapy to reduce pain, increase physical activity and improve physical functioning. However, the therapy is costly and adherence to home exercises appeared to be disappointing. In a blended intervention face-to-face exercise therapy can be partly substituted by an online intervention in order to generate a cheaper intervention. The online part of such an intervention has the potential to support home exercises because of its 24/7 accessibility. Research into the development of blended interventions is limited.
Objectives The objective of this study is to describe the iterative development process and final version of ‘E-Exercise: a blended exercise intervention for patients with hip and/or knee osteoarthritis’
Methods E-Exercise development followed four steps: 1) conceptualization (critique of literature and theory); 2) formative research (focus groups with physical therapists and interviews with patients); 3) pilot testing (pilot, n=8 patients); and, 4) qualitative evaluation of the intervention with physical therapists (n=7) and patients (n=6).
During the developmental process of E-Exercise a project group of relevant stakeholders focused on the development of a business model on implementation of E-Exercise.
Results A final version of the E-Exercise intervention has been developed. E-Exercise is a 12-week intervention, consisting of maximum five face-to-face physical therapy contacts (in week 1, 2, 6 and 12) supplemented with a web-based program. The web-based program contains three different sections. In the “activity” section, the patient selects a central activity, for example walking or cycling. Each week, new assignments are generated to gradually increase patients' load ability for these specific activity. The “exercise” section contains strength and stability exercises and the “information” section includes OA related topics. Key findings identified throughout the development process of the E-Exercise program were: the need for more insight in the web-based part of the intervention (by physical therapists), and the positive evaluation of E-Exercise of both physical therapists and patients.
Considering the business model on E-Exercise an overview have been made on the wishes and the contributions of the different stakeholders concerning this intervention.
Conclusions The final version of E-Exercise feasible to use in physical therapy practice for patients with osteoarthritis of hip or knee. E-Exercise is being evaluated in a community-based randomised controlled efficacy trial. During this evaluation a final business model will be developed.
Acknowledgements This study is financed bij ZonMW, the Dutch Rheumatoid Arthritis Foundation and the Royal Dutch Society for Physical Therapy
Disclosure of Interest None declared