None listed
Conditions
Brief summary
Osteoarthritis (OA) is the leading cause of pain and disability in Australia and the knee is commonly affected. OA is the 11th highest contributor to global disability and in 2008-9 was the eighth most-managed problem by Australian GPs. Exercise is a core component of best-practice management, yet access by Australians to appropriately-qualified health care providers for exercise prescription and advice is very limited. Furthermore, uptake of exercise by people with knee OA in Australia is grossly inadequate, and long-term adherence is poor. This randomised controlled trial (RCT) will evaluate the effectiveness of telephone-delivered exercise advice and behaviour change support by physiotherapists for improving knee pain and function in people with knee OA. The service will be embedded into the Musculoskeletal Help Line that is provided by Arthritis & Osteoporosis Victoria.
Interventions
Intervention: In addition to the control treatment, people allocated to intervention will also receive verbal exercise counselling and support from a physiotherapist over the phone, supplemented by written information about arthritis and the importance of exercise, exercise instructions, links to video clips and/or referral to community exercise services/facilities. Resources will be provided in hard copy via the post. Access to exercise video clips and exercise instructions will be provided vi
Intervention: In addition to the control treatment, people allocated to intervention will also receive verbal exercise counselling and support from a physiotherapist over the phone, supplemented by written information about arthritis and the importance of exercise, exercise instructions, links to video clips and/or referral to community exercise services/facilities. Resources will be provided in hard copy via the post. Access to exercise video clips and exercise instructions will be provided via the internet, using the study website. Five to ten telephone calls (45 min duration for initial call, 20 min duration per subsequent call) will be provided over 6 months. Calls will occur in weeks 2, 4, 8, 13 & 21 of the 26 week intervention period. The physiotherapist will use as few or as many of the five additional phone calls as they deem appropriate per individual participant and will schedule these at a mutually agreed upon time. Together with the participant, the physiotherapist will devise a specific strengthening program, as well as a plan to increase general physical activity levels. The content and intensity of the strengthening exercise program will be determined by the physiotherapist in discussion with the participant. In subsequent calls, the physiotherapist will monitor progress, adjust the program and goals and provide support by increasing participant knowledge and understanding, motivation, confidence and self-efficacy for exercise. Physiotherapist will be trained in, and will use best practice principles for supporting behaviour change, when delivering the intervention. Adherence to the intervention will be monitored by a) recording the number of telephone calls the participant participated in; b) asking participants to self-rate their overall adherence to both the strengthening exercises and the general physical activity plan at 6 and 12 month follow up and; c) asking participants to record their use of community exercise facilities/services.
Sponsors
The University of Melbourne
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
45 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Participants aged 45 years or over with painful knee osteoarthritis (OA) will be recruited. People will be eligible if they report average knee pain of at least 4 on 11-point numerical rating scale (NRS), have had knee pain for greater than 3 months, have activity-related joint pain and have morning stiffness <30 minutes duration.
Exclusion criteria
- on the waiting list for a knee or hip replacement, or planning any lower limb or spinal surgery in the coming 12 months - have had a knee joint replacement in the affected knee - undergone knee surgery in the prior 3 months - currently undertaking exercise prescribed by a health professional in the past 6 months - unable to speak or read English - unable to use/access a telephone - self-reported diagnosis of rheumatoid arthritis - any neurological condition (such as stroke, multiple sclerosis, polio, a neuropathy, peripheral nerve disease, Parkinson’s disease) that affects ability to exercise safely - any cardiovascular condition (such as unstable cardiac disease, uncontrolled hypertension, uncontrolled metabolic disease, abdominal aortic aneurysm) - fail pre-exercise screening (consists of seven questions which are answered YES or NO, and are designed to identify individuals with signs or symptoms of underlying disease, or who may be at higher risk of an adverse event during exercise) - fail additional questions regarding falls risk or 'house bound' - which have been added to identify whether or not individuals have a higher risk of falls/adverse events when carrying out home exercises. -unable to commit to the study for 12 months.
Outcome results
None listed