Osteoarthritis: less pain and better functioning in daily life due to web-based program

Patients with osteoarthritis of the knee and/or hip have less pain after taking part in a web-based exercise program. After participation in the program, walking, cycling and shopping were all found to be considerably easier. This has become clear from research at the Netherlands Institute for Health Services Research (NIVEL) for which Daniël Bossen has been awarded his doctorate on May 9, 2014 from the University of Tilburg.

Patients who have osteoarthritis experience the disease as wear and tear in their joints. They have a lot of pain when they move so they tend to move less and less frequently. This results in a vicious circle in which the osteoarthritis and its consequences only become worse. The exact cause of osteoarthritis has still not been discovered. However, we do now know that moderate-intensity activity can help to relieve osteoarthritis symptoms. “Join2move” – the web-based program that has been developed by NIVEL – appears to have helped people with osteoarthritis to start becoming physically active again and to reduce their pain.
 
Climbing stairs and cycling
After three months patients in the program were functioning better in their daily lives. Activities such as going up and down stairs, squatting, walking and going shopping became easier and they had less pain. Moreover, after three months, 44% of patients following the program were experiencing fewer problems with their osteoarthritis; in the control group this was only 7%. After one year, the program participants appeared to be more physically active than those in the control group. While pain and daily functioning remained at the improved level after one year, the difference with the control group was not significant.
 
Moving with pain
NIVEL researcher Daniël Bossen explains: “The program makes people with osteoarthritis aware that despite the pain they are able to move more, for example, by walking or cycling. It does not make the osteoarthritis any worse. They feel that they are improving, they notice that they have less pain and experience fewer restrictions in their daily life. The program also functions as an incentive to exercise regularly.”
 
Using the website
Not all participants follow the program regularly; half of them do not visit the website regularly or do not fill out all the assignments. Bossen: “Some of these people benefit much more from personal guidance so a web-based program is not suitable for them. However, many of these people might pick up quite a few tips from such a website without actually following the program. These people do not like to be led by the hand by a website every week. They do, however, follow the advice to take more exercise and do this in their own way.”
 
Research
Research into the effectiveness of the program was carried out by following a group of 100 patients with osteoarthritis of the knee and/or hip who took part in the 9-week, web-based program called Join2move. They were compared with an equally sized control group who were not following the program. Measurements were taken at baseline, after three months and after one year.
 
The website www.artroseinbeweging.nl will remain online and can be used by anyone with osteoarthritis. In order to optimize the use of the web-based program, NIVEL has started the project E-Exercise, in which a combined intervention of physiotherapy with the web-based program will be investigated.