None listed
Conditions
Brief summary
Osteoarthritis (OA) of hip/knee is a painful condition which significantly impacts daily activities. Individuals with OA often resort to a sedentary lifestyle for fear of progression of the disease. Ironically, this can lead to development of co-morbidities such as obesity and set up a vicious cycle of condition deterioration and further inactivity. Nevertheless, undertaking physical activity is a challenge in later stages of hip/knee OA with significant pain and disability reinforcing the fear of movement. The aims of this study are to identify individuals with early signs of OA in the community and determine the feasibility of a physical activity intervention to improve self-management of the condition and exercise behaviour.
Interventions
Group 1 (Tailored physiotherapy intervention - combination of exercise and manual therapy for six weeks): The exercise and manual therapy will be modified to address the individuals’ impairments (as per the assessment), aimed at improving/modifying the quality of joint movement and pain modulation.
The exercise therapy will consist of a 20 minute supervised exercise programme including neuromuscular control exercises in weight bearing, muscle stretching and strengthening exercises. Exercises wil
Group 1 (Tailored physiotherapy intervention - combination of exercise and manual therapy for six weeks): The exercise and manual therapy will be modified to address the individuals’ impairments (as per the assessment), aimed at improving/modifying the quality of joint movement and pain modulation. The exercise therapy will consist of a 20 minute supervised exercise programme including neuromuscular control exercises in weight bearing, muscle stretching and strengthening exercises. Exercises will be tailored according to the clinical presentation and, an individualised home programme will be prescribed. The targets to achieve will be discussed with the participant. and set accordingly. Participants will be encouraged to carry out the set of exercises at least once a day for about 30 minutes and maintain an exercise diary to self-monitor exercise behaviour and adherence. The home programme will be reviewed during every visit and progressed as appropriate to the participant. Manual therapy is operationally defined as the external force applied to the joint by a physiotherapist. Parameters of force such as magnitude of force, frequency and direction of treatment will be informed by clinical presentation and informed by the evidence. The manual therapy session will approximately be 20 minutes long. The supervised exercise and manual therapy will occur in the same session, with one session/week for six weeks. After completion of the six-week intervention programme, participants will be encouraged to continue the home programme for further six weeks. In total, the home programme will take place for 12 weeks. Group 2 (Tailored physiotherapy and a tailored physical activity programme): This group will receive a physical activity programme in addition to the tailored physiotherapy intervention (supervised exercise, manual therapy and home programme). The physical activity programme consists of a pedometer-driven walking programme based on the self-regulation theory. The intervention includes self-monitoring of the physical activity (step count) and a weekly goal setting to increase the level of physical activity by at least 5%. Participants will be required to walk at least 30 minutes/day in one-week period to meet the recommended international guidelines for physical activity. The physiotherapist delivering the intervention will have a facilitatory role in increasing the physical activity levels for the first six weeks. The therapist will review the pedometer logbook and provide feedback on the physical activity levels when the participant attends for treatment. For a further six weeks the participants will be encouraged to continue the pattern of increasing physical activity and reinforced with a weekly follow-up phone call, which will be approximately 15 minutes long.
Sponsors
Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
40 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
All potential participants aged 40-75 years who satisfy American College of Rheumatology clinical criteria for classification of hip/knee OA will be considered for inclusion. Additionally participants should not be regularly physically active (less than 7500 steps/day), but able to walk for at least 10 minutes will only be considered for the study.
Exclusion criteria
Participants will be excluded if they had undergone any hip/knee surgery within the past 12 months, have a history of lower limb joint replacement, have had an intra-articular steroid injection within the past 12 months, have history of inflammatory/systemic arthritis. Participants with a hip/knee joint pain from a source other than the respective joint (confirmed by clinical examination) will also be excluded.
Outcome results
None listed