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FRI0749-HPR The effect of a supported osteoarthritis self-management program on physical activity, pain, quality of life and self-efficacy. an intervention study with a reference group
  1. TSJ Jönsson1,
  2. CA Thorstensson2,
  3. E Ekvall Hansson3,
  4. L Dahlberg4
  1. 1Department of orthopaedics, Institute of Clinical Sciences, Lund
  2. 2Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, Gothenburg
  3. 3Department of Health Sciences, Division of Physiotherapy
  4. 4Department of Orthopedics, Institute of Clinical Sciences, Lund, Sweden

Abstract

Background People with osteoarthritis are less physical active than others and a large part are sedentary. It is unclear how to increase the physical activity level for patients with osteoarthritis.

Objectives The primary aim of this study was to evaluate the effects from an evidence based supported osteoarthritis self-management program in patients with knee or hip osteoarthritis on physical activity. Secondary aim were to evaluate the effect on pain, quality of life and self-efficacy.

Methods An intervention study with a reference group in which 104 patients (29–75 years) with knee (n=84) or hip (n=20) osteoarthritis participated in the intervention. Patients were referred to a supported osteoarthritis self-management program that include physical therapist delivered information and individually adapted exercise. The reference group comprised 28 patients (49–75 years) with knee (n=16) or hip (n=12) osteoarthritis from the waiting list at an orthopedic university clinic. Outcome measurements were made at baseline, 3 and 12 months. Physical activity were objective measured with an accelerometer. The secondary outcomes were patient reported, Visual Analog Scale (VAS) were used to measure pain, EQ-5D to measure quality of life and Arthritis Self Efficacy Scale to measure self-efficacy.

Results The supported osteoarthritis self-management program did not improve physical activity (p=0,77) between baseline and 3 month follow up compared to the reference group. But it did improve pain (p=0,02), quality of life (p=0,002), self-efficacy-other (p=0,015) and self-efficacy-pain (p=0,033) between baseline and 3 month follow up compared to the reference group. The improvements in pain and quality of life in the intervention group persisted at 12 month follow-up.

Conclusions The supported osteoarthritis self-management program delivering information and individualized exercise according to the national program BOA in Sweden improved pain, quality of life and self-efficacy. Despite these results, the physical activity level were not improved. More research on how to improve the physical activity in patients with osteoarthritis is needed.

References

  1. Cross M, Smith E, Hoy D, Nolte S, Ackerman I, Fransen M, et al. The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis. 2014;73(7):1323–30.

  2. Zhang W, Nuki G, Moskowitz RW, Abramson S, Altman RD, Arden NK, et al. OARSI recommendations for the management of hip and knee osteoarthritis: part III: Changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthritis Cartilage. 2010;18(4):476–99.

  3. Thorstensson CA, Garellick G, Rystedt H, Dahlberg LE. Better Management of Patients with Osteoarthritis: Development and Nationwide Implementation of an Evidence-Based Supported Osteoarthritis Self-Management Programme. Musculoskeletal care. 2014.

  4. Wallis JA, Webster KE, Levinger P, Taylor NF. What proportion of people with hip and knee osteoarthritis meet physical activity guidelines? A systematic review and meta-analysis. Osteoarthritis Cartilage. 2013;21(11):1648–59.

References

Acknowledgements Grants were received from The Academy of Caring Sciences, Skåne University Hospital and The Swedish Rheumatism Association in Gothenburg.

Disclosure of Interest None declared

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