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Association between metabolic conditions, physical activity and self-efficacy before and after a first-line exercise and education intervention for osteoarthritis : a longitudinal register study using the SOAD cohort

Recenti, Filippo LU ; Battista, Simone LU orcid ; Lohmander, Stefan LU orcid ; Vinblad, Johanna ; Kiadaliri, Ali LU orcid ; Abbott, Allan ; Rolfson, Ola ; Englund, Martin LU orcid ; Testa, Marco and Dell’Isola, Andrea LU orcid (2025) In RMD Open 11(3).
Abstract

Objectives To investigate the association of diabetes, hypertension and overweight/obesity with physical activity (PA), self-efficacy for pain and self-efficacy for other symptoms before and after a 6- week exercise and education intervention for knee and hip osteoarthritis (OA), and to assess outcome disparities based on metabolic health. Methods Register-based cohort study using the Swedish Osteoarthritis and Diabetes cohort. We used Body Mass Index, medical records and medication dispensation to define overweight/obesity, hypertension and diabetes at baseline (exposures). PA was self-reported (weekly minutes), and self-efficacy was measured using the ‘Arthritis Self-Efficacy Scale’ (ASES) (score 10–100) (outcomes). We used linear... (More)

Objectives To investigate the association of diabetes, hypertension and overweight/obesity with physical activity (PA), self-efficacy for pain and self-efficacy for other symptoms before and after a 6- week exercise and education intervention for knee and hip osteoarthritis (OA), and to assess outcome disparities based on metabolic health. Methods Register-based cohort study using the Swedish Osteoarthritis and Diabetes cohort. We used Body Mass Index, medical records and medication dispensation to define overweight/obesity, hypertension and diabetes at baseline (exposures). PA was self-reported (weekly minutes), and self-efficacy was measured using the ‘Arthritis Self-Efficacy Scale’ (ASES) (score 10–100) (outcomes). We used linear mixed-effect models to estimate associations between exposures and outcomes, adjusted for confounders. Results We included 80 893 individuals with knee or hip OA. Those with metabolic conditions consistently showed lower PA and self-efficacy, with baseline disparities persisting after the intervention, particularly when all three conditions coexisted (PA difference: baseline 107 min [95% CI: 97; 118], 3-month 97 [86; 108], 12-month 109 [95; 123]; ASES-pain difference: baseline 5.6 [3.9; 7.3], 3-month 5.9 [4.1; 7.7], 12-month 8.2 [6.1; 10.4]; ASES-other symptoms difference: baseline 6.1 [4.6; 7.7], 3-month 6.4 [4.8; 8.0], 12-month 8.2 [6.3; 10.1]). Conclusions Metabolic conditions were associated with lower PA and self-efficacy, with differences increasing with the number of co-existing conditions. The baseline disparities associated with metabolic conditions persisted after the intervention, with both groups showing improvement at 3 months but reverting to baseline by 12 months. This suggests that current guideline-based interventions for OA may not reduce long-term disparities related to metabolic conditions.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Hypertension, Osteoarthritis, Rehabilitation
in
RMD Open
volume
11
issue
3
article number
e005804
publisher
BMJ Publishing Group
external identifiers
  • pmid:41022523
  • scopus:105017581202
ISSN
2056-5933
DOI
10.1136/rmdopen-2025-005804
language
English
LU publication?
yes
id
7773bf3a-882b-4ed8-a861-5f05c5bf4300
date added to LUP
2025-11-26 13:52:48
date last changed
2026-01-08 02:08:35
@article{7773bf3a-882b-4ed8-a861-5f05c5bf4300,
  abstract     = {{<p>Objectives To investigate the association of diabetes, hypertension and overweight/obesity with physical activity (PA), self-efficacy for pain and self-efficacy for other symptoms before and after a 6- week exercise and education intervention for knee and hip osteoarthritis (OA), and to assess outcome disparities based on metabolic health. Methods Register-based cohort study using the Swedish Osteoarthritis and Diabetes cohort. We used Body Mass Index, medical records and medication dispensation to define overweight/obesity, hypertension and diabetes at baseline (exposures). PA was self-reported (weekly minutes), and self-efficacy was measured using the ‘Arthritis Self-Efficacy Scale’ (ASES) (score 10–100) (outcomes). We used linear mixed-effect models to estimate associations between exposures and outcomes, adjusted for confounders. Results We included 80 893 individuals with knee or hip OA. Those with metabolic conditions consistently showed lower PA and self-efficacy, with baseline disparities persisting after the intervention, particularly when all three conditions coexisted (PA difference: baseline 107 min [95% CI: 97; 118], 3-month 97 [86; 108], 12-month 109 [95; 123]; ASES-pain difference: baseline 5.6 [3.9; 7.3], 3-month 5.9 [4.1; 7.7], 12-month 8.2 [6.1; 10.4]; ASES-other symptoms difference: baseline 6.1 [4.6; 7.7], 3-month 6.4 [4.8; 8.0], 12-month 8.2 [6.3; 10.1]). Conclusions Metabolic conditions were associated with lower PA and self-efficacy, with differences increasing with the number of co-existing conditions. The baseline disparities associated with metabolic conditions persisted after the intervention, with both groups showing improvement at 3 months but reverting to baseline by 12 months. This suggests that current guideline-based interventions for OA may not reduce long-term disparities related to metabolic conditions.</p>}},
  author       = {{Recenti, Filippo and Battista, Simone and Lohmander, Stefan and Vinblad, Johanna and Kiadaliri, Ali and Abbott, Allan and Rolfson, Ola and Englund, Martin and Testa, Marco and Dell’Isola, Andrea}},
  issn         = {{2056-5933}},
  keywords     = {{Hypertension; Osteoarthritis; Rehabilitation}},
  language     = {{eng}},
  number       = {{3}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{RMD Open}},
  title        = {{Association between metabolic conditions, physical activity and self-efficacy before and after a first-line exercise and education intervention for osteoarthritis : a longitudinal register study using the SOAD cohort}},
  url          = {{http://dx.doi.org/10.1136/rmdopen-2025-005804}},
  doi          = {{10.1136/rmdopen-2025-005804}},
  volume       = {{11}},
  year         = {{2025}},
}