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Design and testing a web-based physical activity intervention for patients with osteoarthritis in hip and/or knee.

Bossen, D. Design and testing a web-based physical activity intervention for patients with osteoarthritis in hip and/or knee. Osteoarthritis and Cartilage: 2012, 20(Suppl. 1), p. S283. Abstract. World Congress on Osteoarthritis. 26-29 april 2012, Barcelona.
Purpose: Due to elevated fear of pain, catastrophizing thoughts and joint stiffness, a large group of patients with hip and/or knee osteoarthritis (OA) remain sedentary. Although inactivity may enhance in short-term pain reduction, prolonged inactivity may augment functional decline. Therefore, we developed a web-based intervention that provides a highly individualized behaviorally based physical activity (PA) program. The aim of this study is to describe the development, preliminary effectiveness and usability of a 9 week website intervention on PA behavior change in individuals with hip and/or knee OA. Methods: We used an iterative design methodology for the creation of a web-based intervention. The intervention incorporates core principles of the behaviour graded activity theory. A pilot study prototype was tested trough a non-randomized pilot study among 20 patients with OA. PA levels and pain scores were measured trough online questionnaires (week 0, 6 and 12). Subsequently, a heuristic evaluation and a thinking aloud approach were performed to determine the usability of the intervention. Information about user satisfaction was collected through semi structured face-to-face interviews. Results:After several iterations of testing and revising, we developed a final version of the web-based intervention.The PA program includes an introduction module and 8 text based week assignments. Twenty OA patients, between 50 and 80 years of age, participated in the pilot study and received the intervention. After 12 weeks, there was a non-significant increase in PA (1697 to 2044 minutes per week).After six weeks, pain scores increased from 5.3 to 6.6 (p=0.04). After 12 weeks, however, this significant difference disappeared. Although usability tests revealed some usability issues, participants considered the intervention as helpful. In particular, users were enthusiastic to perform physical exercises in their own time and at their own pace. Conclusions: This paper outlines the development and usability of a web-based PA intervention for patients with hip and/or knee OA. The preliminary results from the pilot study suggests that the intervention is promising in the promotion of PA, even though effects were not statistical significant.