Effect of Structured Info and Adapted Exercise in OA
Condition: Osteoarthritis
MeSH terms: Osteoarthritis
Study type: Interventional

Summary: 
      Physical activity level is measured at baseline and after 3 and 12 months after structured
      information and individually adapted exercise for patients with osteoarthritis in hip or
      knee.

      The hypothesis of this study is that a supported self management of osteoarthritis program
      will increase the level of physical activity in patients with osteoarthritis in hip or knee.
      The second hypothesis is that patients with osteoarthritis in knee will increase their level
      of physical activity more than patients with osteoarthritis in hip.
    

Detailed description: 
      Osteoarthritis (OA) is one of our most common chronic joint disorders. The World Health
      Organization (WHO) has estimated that every second woman and every fourth man over the age of
      60 suffer some form of OA. OA is most common in hands, knee, hip and back. OA is a rheumatic
      disorder which affects the whole joint and may start as early as in the age of 30. The main
      symptoms are pain, stiffness and decreased quality of life.

      The primary goals of OA management are to reduce the symptoms. Patient education and
      exercises are recommended as basic treatment according to national as well as international
      guidelines.

      It is known that the level of physical activity decreases with age and that woman are less
      physical active than men. A study of healthy women older than 56 years showed that the level
      of activity decreased by 10 minutes per year, for every five year increase in age. OA is more
      common in women and is an irreversible disease, which means that the proportion of older
      women with osteoarthritis is large.

      In addition OA is the most common cause of inactivity among the elderly and many fear that
      activity will further damage the joints. Inactivity is a large risk factor for poor physical
      and psychological health as well as premature death. Level of physical activity in people
      with OA has mainly been evaluated by self-assessment questionnaires. People with hip OA are
      more active than people with knee OA and the correlation between the degree of radiographic
      changes and physical activity is weak. Only 30% with early OA of the knee in the age group
      35-65 years meet the recommendations for physical activity performed at least 30 minutes per
      day of moderate intensity, five days per week, measured by an accelerometer.

      The primary aim of this study is to determine the effects of structured information and
      individually adapted exercises, delivered as a supported self-management osteoarthritis
      program, on overall levels of physical activity of moderate and vigorous intensity in
      patients with hip or knee OA. The secondary aim is to compare the level of physical activity
      in patients with hip and knee OA.

      Supported self-management program for patients with osteoarthritis has been studied before
      and it's shown that it improves the quality of life, the physical function and decrease pain.
      No studies have investigated the effect of supported self-management on the level of physical
      activity.

      This is an observational study with control group. Assessments are made at baseline and at 3
      and 12 month after the supported self-management course.

      The self-management program comprise three theoretical sessions, each of about 90 minutes,
      led by a physical therapist and held as group sessions with about 10 participants in each
      group. On the third session an osteoarthritis communicator participates. That is a person
      with osteoarthritis who communicate the lifestyle changes he/she have done to live a good
      life with OA. After the theoretical part the patients are offered an individually adapted
      exercise program, and the opportunity to practice this program together with others under
      supervision of a physical therapist twice per week for 6 weeks. Patients are also encouraged
      to find one or two exercises to perform continuously as home exercises. During the program
      home exercise and other alternatives as changing activity, using walking sticks, pain
      management ect are introduced in order to maintain the level of physical activity over an
      extended period of time. The importance of being physically active for a long time is
      accentuated in all aspects of the patient education. The primary aim of the supported
      self-management program is to increase the level of physical activity and empower patients to
      manage their disease, avoid illness and live a good life despite osteoarthritis.

      Physical activity is measured with an accelerometer at baseline, 3 month and 12 month. We
      will also study the correlation between objectivity measured physical activity with physical
      activity questionnaire (UCLA), quality of life (EQ-5D), pain (VAS 0-100) and comorbidity.

      All subjects in our study are also registered in a Swedish national quality register called
      Better management of patients with osteoarthritis (BOA). Some of the data used in the present
      study are collected from the register.
    

Intervention name(s): A supported self management of osteoarthritis program
Intervention type(s): Behavioral
Intervention description(s): Three theoretical sessions, each of about 90 minutes, held as group sessions with about 10 participants in each group. After the intervention patients are offered an individual exercise program, and the opportunity to practice this program together with others under supervision of a physical therapist for 6 weeks.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Osteoarthritis knee; Osteoarthritis hip; Physical activity; accelerometer