Internet programme helps arthritis patients exercise more

Sufficient physical activity helps patients with knee or hip osteoarthritis to function better, without causing any more pain. The free Internet programme Join2move, which was developed specifically for the purpose, has been tested in the target group and adjusted during its various phases. Researchers at NIVEL, the Netherlands Institute for Health Services Research, are publishing the study design and the initial results in BMC Medical Informatics and Decision Making.

Because arthritis patients suffer a lot of pain, they become less active as time progresses. However, the inactivity only makes the pain and the limitations worse. This is despite the fact that earlier studies have shown that sufficient activity does not worsen the pain symptoms, while it does help reduce physical limitations. Moreover, sufficient activity can even lead to operations being put off. NIVEL has therefore developed an Internet programme for patients with knee or hip osteoarthritis that helps them exercise more, at their own pace.
 
Motivation
“People often think that activity makes the pain worse,” says NIVEL researcher Daniël Bossen. “If they take part in Join2move (ArtroseinBeweging.nl), though, they learn and can experience for themselves that the pain is not linked to more exercise. That insight motivates them to be more active.”
The Internet programme has been tested, adjusted and tested again in several phases with osteoarthritis patients. The development process can also be used as a template for other development work. Moreover, the programme is fully automated, which enables it to be reached by a wide audience with a minimum impact on scarce care resources. Due to an increase in obesity and an ageing population profile, there will be more osteoarthritis patients with care needs in future.
 
Pilot study
In the article, the researchers report on a pilot study among twenty patients with knee or hip arthritis who used the Join2move to help them exercise more. After a twelve-week period, the pain was unchanged but they were exercising a lot more. In addition, the researchers did two user tests in which people carried out tasks as instructed, with the researchers watching exactly where the programme went wrong and what was unclear or could be improved. This information was used to fine-tune Join2move further. Results are expected shortly from a larger study with more patients. 

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