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Behavioural graded activity results in better exercise adherence and more physicial activity than usual care in people with osteoarthritis: a cluster-randomised trial.
Pisters, M.F., Veenhof, C., Schellevis, F., Twisk, J.W.R., Dekker, J., Bakker, D.H. de. Behavioural graded activity results in better exercise adherence and more physicial activity than usual care in people with osteoarthritis: a cluster-randomised trial. Journal of Physiotherapy: 2010, 56(1), p. 41-47.
OBJECTIVE: To determine the effect of patient exercise adherence within the prescribed physical therapy treatment period and after physical therapy discharge on patients' outcome on pain, physical function and patient self-perceived effect in individuals with osteoarthritis (OA) of the hip and/or knee. METHODS: Prospective observational follow-up study, in which 150 patients with OA of the hip and/or knee receiving exercise therapy were followed 60 months. Data were obtained from a randomized controlled trial, with assessments at baseline, 3, 15, and 60 months follow-up. The association between exercise adherence and patients' outcome on pain, physical function and self-perceived effect was examined using generalized estimating equations (GEE) analyses. RESULTS: Adherence to recommended home exercises and being more physically active was significantly associated with better treatment outcome on pain, self-reported physical function, physical performance and self-perceived effect. The association between adherence and outcome was consistent over time. Adherence to home activities was only associated with better self-perceived effect. CONCLUSION: Better adherence to recommended home exercises as well as being more physically active improves the long-term effectiveness of exercise therapy in patients with osteoarthritis of the hip and/or knee. Both within and after the treatment period better adherence is associated with better patients' outcome on pain, physical function, and self-perceived effect. Since exercise adherence declines over time, future research should focus on how exercise behavior can be stimulated and maintained in the long-term.(aut. ref.)
OBJECTIVE: To determine the effect of patient exercise adherence within the prescribed physical therapy treatment period and after physical therapy discharge on patients' outcome on pain, physical function and patient self-perceived effect in individuals with osteoarthritis (OA) of the hip and/or knee. METHODS: Prospective observational follow-up study, in which 150 patients with OA of the hip and/or knee receiving exercise therapy were followed 60 months. Data were obtained from a randomized controlled trial, with assessments at baseline, 3, 15, and 60 months follow-up. The association between exercise adherence and patients' outcome on pain, physical function and self-perceived effect was examined using generalized estimating equations (GEE) analyses. RESULTS: Adherence to recommended home exercises and being more physically active was significantly associated with better treatment outcome on pain, self-reported physical function, physical performance and self-perceived effect. The association between adherence and outcome was consistent over time. Adherence to home activities was only associated with better self-perceived effect. CONCLUSION: Better adherence to recommended home exercises as well as being more physically active improves the long-term effectiveness of exercise therapy in patients with osteoarthritis of the hip and/or knee. Both within and after the treatment period better adherence is associated with better patients' outcome on pain, physical function, and self-perceived effect. Since exercise adherence declines over time, future research should focus on how exercise behavior can be stimulated and maintained in the long-term.(aut. ref.)