Abstract
BackgroundKnee osteoarthritis (KOA) is one of the most common chronic diseases in the elderly and is the primary cause of the loss of motor function and disability in this population. Exercise therapy is a core, basic and matureand treatment method of treating patients with KOA. Exercise therapy is “strongly recommended” or “recommended” in the diagnosis and treatment guidelines of osteoarthritis in many countries, and most scholars advocate exercise therapy as the preferred rehabilitation method for KOA patients. However, poor long-term adherence is a serious problem affecting the therapeutic effect of this mature treatment. The objective of this study was to construct a concise and practical adherence rating scale (ARS) based on the exercise therapy adherence prediction model in patients with knee osteoarthritis.MethodsA binary logistic regression model was established, with the adherence of 218 cases of KOA patients as the dependent variable. The patients’ general information, exercise habits, knowledge, attitude, and exercise therapy were independent variables. The regression coefficients were assigned to various variables in the model, and the ARS was constructed accordingly. Receiver operating characteristic curves and curve fitting were used to analyse the effect of the ARS in predicting the adherence and to determine the goodness of fit for the adherence. The external validity of the ARS was examined in a randomized controlled trial.ResultsThe construction of the adherence model and the ARS included the following variables: age (1 point), education level (1 point), degree of social support (2 points), exercise habits (3 points), knowledge of KOA prevention and treatment (2 points), degree of care needed to treat the disease (1 point), familiarity with exercise therapy (4 points) and treatment confidence (3 points). The critical value of the total score of the ARS was 6.50, with a sensitivity of 87.20% and a specificity of 76.34%.ConclusionsA KOA exercise therapy adherence model and a simple and practical ARS were constructed. The ARS has good internal validity and external validity and can be used to evaluate the adherence to exercise therapy in patients with KOA.
Highlights
Knee osteoarthritis (KOA) is one of the most common chronic diseases in the elderly and is the primary cause of the loss of motor function and disability in this population
In disease prevention or treatment, the World Health Organization (WHO) has defined adherence as the degrees of consistency of the behaviours of the patient concerning the diet, lifestyle and medication with the health care programme developed by the medical practitioner [1,2,3]
Based on the Morisky scale, an adherence scale for KOA exercise therapy was developed, including four questions: (1) Have you ever forgotten to exercise once or more during exercise therapy? (2) Do you often not take exercise seriously? (3) If the joint pain and swelling symptoms are improved, do you stop exercising or reduce the number of exercises? (4) If you feel physically uncomfortable after exercise, do you stop exercising or reduce the number of exercises? For each question, the answer of “yes” was recorded as 1 point, and the answer of “no” was recorded as 0 points
Summary
Knee osteoarthritis (KOA) is one of the most common chronic diseases in the elderly and is the primary cause of the loss of motor function and disability in this population. The WHO has indicated that, compared with the development of a new treatment, the improvement in the patient’s adherence to the current mature treatment will result in greater health benefits [1]. Exercise therapy is a mature [7] and a core, basic and front-line treatment method of treating KOA [8,9,10,11,12]. Large numbers of empirical studies have provided evidence that exercise therapy can effectively relieve knee pain, reduce the rate of disability, improve knee function and improve the patient’s quality of life [15,16,17,18]. Improving adherence to this mature exercise therapy will enable KOA patients to reap more health benefits
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