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
Authors: TSJ Jönsson, CA Thorstensson, E Ekvall Hansson, L Dahlberg
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> 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. <h3>Objectives</h3> 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. <h3>Methods</h3> 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. <h3>Results</h3> The supported osteoarthritis self-management program did not improve physical activity <i>(p=0,77</i>) between baseline and 3 month follow up compared to the reference group. But it did improve pain (<i>p=0,02</i>), quality of life (<i>p=0,002</i>), self-efficacy-other (<i>p=0,015</i>) and self-efficacy-pain (<i>p=0,033</i>) 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. <h3>Conclusions</h3> 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. <h3>References</h3> 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. 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. 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. 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. <h3>Acknowledgements</h3> Grants were received from The Academy of Caring Sciences, Skåne University Hospital and The Swedish Rheumatism Association in Gothenburg. <h3>Disclosure of Interest</h3> None declared