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The effect of education and supervised exercise on physical activity, pain, quality of life and self-efficacy - an intervention study with a reference group

Jönsson, Thérése LU ; Ekvall Hansson, Eva LU ; Thorstensson, Carina A. ; Eek, Frida LU ; Bergman, Patrick and Dahlberg, Leif E. LU (2018) In BMC Musculoskeletal Disorders 19(1).
Abstract

Background: Individuals with knee and hip osteoarthritis (OA) are less physically active than people in general, and many of these individuals have adopted a sedentary lifestyle. In this study we evaluate the outcome of education and supervised exercise on the level of physical activity in individuals with knee or hip OA. We also evaluate the effect on pain, quality of life and self-efficacy. Methods: Of the 264 included individuals with knee or hip OA, 195 were allocated to the intervention group. The intervention group received education and supervised exercise that comprised information delivered by a physiotherapist and individually adapted exercises. The reference group consisted of 69 individuals with knee or hip OA awaiting joint... (More)

Background: Individuals with knee and hip osteoarthritis (OA) are less physically active than people in general, and many of these individuals have adopted a sedentary lifestyle. In this study we evaluate the outcome of education and supervised exercise on the level of physical activity in individuals with knee or hip OA. We also evaluate the effect on pain, quality of life and self-efficacy. Methods: Of the 264 included individuals with knee or hip OA, 195 were allocated to the intervention group. The intervention group received education and supervised exercise that comprised information delivered by a physiotherapist and individually adapted exercises. The reference group consisted of 69 individuals with knee or hip OA awaiting joint replacement and receiving standard care. The primary outcome was physical activity (as measured with an accelerometer). The secondary outcomes were pain (Visual Analog Scale), quality of life (EQ-5D), and self-efficacy (Arthritis Self-Efficacy Scale, pain and other symptoms subscales). Participants in both groups were evaluated at baseline and after 3 months. The intervention group was also evaluated after 12 months. Results: No differences were found in the number of minutes spent in sedentary or in physical activity between the intervention and reference groups when comparing the baseline and 3 month follow-up. However, there was a significant difference in mean change (mean diff; 95% CI; significance) between the intervention group and reference group favoring the intervention group with regard to pain (13; 7 to 19; p < 0.001), quality of life (− 0.17; − 0.24 to − 0.10; p < 0.001), self-efficacy/other symptoms (− 5; − 10 to − 0.3; p < 0.04), and self-efficacy/pain (− 7; − 13 to − 2; p < 0.01). Improvements in pain and quality of life in the intervention group persisted at the 12-month follow-up. Conclusions: Participation in an education and exercise program following the Swedish BOA program neither decreased the average amount of sedentary time nor increased the level of physical activity. However, participation in such a program resulted in decreased pain, increased quality of life, and increased self-efficacy. Trial registration: The trial is registered with ClinicalTrials.gov. Registration number: NCT02022566 . Retrospectively registered 12/18/2013.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Accelerometer, Exercise, Hip, Knee, Osteoarthritis, Patient education, Physical activity
in
BMC Musculoskeletal Disorders
volume
19
issue
1
article number
198
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85050536520
  • pmid:30037339
ISSN
1471-2474
DOI
10.1186/s12891-018-2098-3
language
English
LU publication?
yes
id
a0b7415d-dba6-4079-959e-dd20a1be85bf
date added to LUP
2018-09-03 15:18:38
date last changed
2024-04-01 09:48:48
@article{a0b7415d-dba6-4079-959e-dd20a1be85bf,
  abstract     = {{<p>Background: Individuals with knee and hip osteoarthritis (OA) are less physically active than people in general, and many of these individuals have adopted a sedentary lifestyle. In this study we evaluate the outcome of education and supervised exercise on the level of physical activity in individuals with knee or hip OA. We also evaluate the effect on pain, quality of life and self-efficacy. Methods: Of the 264 included individuals with knee or hip OA, 195 were allocated to the intervention group. The intervention group received education and supervised exercise that comprised information delivered by a physiotherapist and individually adapted exercises. The reference group consisted of 69 individuals with knee or hip OA awaiting joint replacement and receiving standard care. The primary outcome was physical activity (as measured with an accelerometer). The secondary outcomes were pain (Visual Analog Scale), quality of life (EQ-5D), and self-efficacy (Arthritis Self-Efficacy Scale, pain and other symptoms subscales). Participants in both groups were evaluated at baseline and after 3 months. The intervention group was also evaluated after 12 months. Results: No differences were found in the number of minutes spent in sedentary or in physical activity between the intervention and reference groups when comparing the baseline and 3 month follow-up. However, there was a significant difference in mean change (mean diff; 95% CI; significance) between the intervention group and reference group favoring the intervention group with regard to pain (13; 7 to 19; p &lt; 0.001), quality of life (− 0.17; − 0.24 to − 0.10; p &lt; 0.001), self-efficacy/other symptoms (− 5; − 10 to − 0.3; p &lt; 0.04), and self-efficacy/pain (− 7; − 13 to − 2; p &lt; 0.01). Improvements in pain and quality of life in the intervention group persisted at the 12-month follow-up. Conclusions: Participation in an education and exercise program following the Swedish BOA program neither decreased the average amount of sedentary time nor increased the level of physical activity. However, participation in such a program resulted in decreased pain, increased quality of life, and increased self-efficacy. Trial registration: The trial is registered with ClinicalTrials.gov. Registration number: NCT02022566 . Retrospectively registered 12/18/2013.</p>}},
  author       = {{Jönsson, Thérése and Ekvall Hansson, Eva and Thorstensson, Carina A. and Eek, Frida and Bergman, Patrick and Dahlberg, Leif E.}},
  issn         = {{1471-2474}},
  keywords     = {{Accelerometer; Exercise; Hip; Knee; Osteoarthritis; Patient education; Physical activity}},
  language     = {{eng}},
  month        = {{06}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Musculoskeletal Disorders}},
  title        = {{The effect of education and supervised exercise on physical activity, pain, quality of life and self-efficacy - an intervention study with a reference group}},
  url          = {{http://dx.doi.org/10.1186/s12891-018-2098-3}},
  doi          = {{10.1186/s12891-018-2098-3}},
  volume       = {{19}},
  year         = {{2018}},
}