POS1466-HPR RELIABILITY, BARRIERS, AND FACILITATORS OF THE SPLIT.OA PHYSICAL PERFORMANCE TESTS BATTERY FOR PEOPLE WITH OSTEOARTHRITIS: A MIXED METHODS STUDY
Authors: M. Curto, A. Moniz, F. Gonçalves, N. Gomes, D. Moço, R. Fernandes, E. B. Cruz, D. Costa
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Osteoarthritis poses a high global burden and impact, which is expected to continue rising over the next few years. Exercise seems to be one of the most effective strategies for the management and prevention of functional decline in people with hip and knee osteoarthritis (HKOA). Current literature suggests that for an adequate and tailored exercise prescription, it is crucial to evaluate patients' physical performance, through functional objective tests. However, evidence on the best combination of instruments for this purpose is still lacking. On the other hand, literature also highlights the lack of adherence by physiotherapists to use assessment tools in their clinical practice, but this problem is being scarcely explored. This study is part of the development of Split.OA, a structured and tailored exercise programme informed by behaviour change, that includes the Split.OA physical performance tests battery to assess people with HKOA. <h3>Objectives:</h3> This study aims to assess the interrater and intra-rater reliability of Split.OA battery for people with HKOA and explore barriers and facilitators to its implementation by physiotherapists. This study will help understand the reliability of Split.OA battery and if it is adapted to the context in which intends to be implemented. <h3>Methods:</h3> A convergent mixed methods study was carried out in two sequential phases. In the quantitative phase, the Split.OA battery was applied to people with HKOA (6 Minute Walk Test, 40 meter Fast Paced Walk Test, 30sec Chair Stand Test, Sit-and-Reach Test, Modified Thomas Test e o Star Excursion Balance Test) in two moments. The first included the assessment for the interrater reliability, by two physiotherapists. Then, 7 to 14 days after the first assessment, the Split.OA battery was once again applied for intra-rater reliability, by only one of those physiotherapists. This was analysed with Interclass Correlation Coefficient (ICC). For the qualitative phase, 2 focus groups were conducted by videoconference with 11 physiotherapists, selected from the collaborating physiotherapists of the quantitative phase and physiotherapists with experience in Split.OA battery tests. Focus groups were moderated by a researcher with experience in qualitative studies and co-moderated by another researcher. The deductive analysis was carried out by two investigators independently. The interview guide and deductive content analysis were guided by the Capacity, Opportunity, Motivation – Behaviour (COM-B) model. <h3>Results:</h3> In total, 21 participants with HKOA were included. The interrater and intra-rater reliability analysis of the tests showed moderate to excellent ICC values (ICC<sub>1,1</sub> 0,726-0,986; ICC<sub>1,k</sub> 0,925-0,966) and (ICC<sub>3,1</sub> 0,699-0,995; ICC<sub>3,k</sub> 0,890-0,975), respectively. The deductive analysis revealed 14 barriers and 16 facilitators, within 5 domains of COM-B. The physiotherapists considered that factors such as their knowledge and the need for training, the necessary resources, their contexts and work teams, beliefs about patients' expectations and communication with them, their beliefs about benefits, the professional responsibility, their confidence and emotions, were highly important for the implementation of the physical performance battery. <h3>Conclusion:</h3> This study provides a contribution about the intra-rater and interrater reliability of a physical performance battery of tests for people with HKOA, showing that even when applied together, physical tests maintain their reliability levels. Additionally, the barriers and facilitators identified will inform possible strategies to be adopted in the future training of physiotherapists and optimise the implementation of Split.OA battery. It may also contribute to the implementation of other performance test batteries in clinical practice. <h3>REFERENCES: NIL. Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>