Abstract
BackgroundBlended care, a combination of online and face-to-face care, is seen as a promising treatment option. However, actual use of blended interventions in practice is disappointing.ObjectiveThe objective of this study was two folded. The first aim was to develop a blended exercise therapy intervention for patients with knee and hip osteoarthritis that matches the values of the users and that can be implemented in the daily routine of physical therapists. The second aim was to investigate the feasibility through interviews and a pilot study.MethodsIn this paper, we employed the first 3 steps of the CeHRes road map to develop a blended intervention for patients with knee and hip osteoarthritis. We used interviews, a focus group and discussions with stakeholders to explore the needs, values, and requirements with respect to our to-be-developed blended intervention, which we called e-Exercise. The first version of e-Exercise was tested in a pilot study. Feasibility outcomes, including recruitment rates within each practice, website usage (assignments completed and website visits), and user satisfaction, were measured. In addition, therapists and patients from the pilot study were interviewed to investigate users’ experiences.ResultsThe study captured important information about stakeholders’ needs and perspectives. Based on our findings, we created a first version and attuned the application’s content, functionality, and structure. Patients and, to lesser extent, physical therapists were satisfied with the e-Exercise intervention. Eight patients were recruited by 8 physical therapists. Of the 8 patients, 6 completed more than 7 of 12 modules.ConclusionsThis study outlines the development and feasibility of a blended exercise therapy intervention for patients with knee and hip osteoarthritis. E-Exercise offers an alternative approach in the physical therapy treatment of knee and hip osteoarthritis. This study provides valuable information to conduct a further trial to evaluate the (cost) effectiveness of e-Exercise compared to usual physical therapy.Trial RegistrationNetherlands Trial Register Number: NTR4224; www.trialregister.nl/trialreg/admin/rctview.asp?TC=4224 (Archived by WebCite at http://www.webcitation.org/6fOK4lrTO).
Highlights
Knee and hip osteoarthritis (OA) are leading causes of disability in older people [1]
E-Exercise offers an alternative approach in the physical therapy treatment of knee and hip osteoarthritis
This study provides valuable information to conduct a further trial to evaluate the effectiveness of e-Exercise compared to usual physical therapy
Summary
Knee and hip osteoarthritis (OA) are leading causes of disability in older people [1]. Patients with knee and hip OA generally tend to avoid physical activity [5], physical exercise is one of the most effective and recommended treatment modalities [3,4]. Generally provided by a physical therapist, is a regimen of physical activities with the aim to change patients’ lifestyle behavior and improve patients’ overall function [6]. Multiple studies have demonstrated the beneficial effects of exercise therapy in patients with knee and hip OA. Exercise therapy has positive effects on pain perception and self-reported physical function [7,8]. Only 7% of all patients with knee and hip OA who are seen in general practice are referred to a physical therapist [9]. Actual use of blended interventions in practice is disappointing
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