Abstract
BackgroundTo obtain information on feasibility and acceptability, as well as preliminary data on efficacy, of an Osteoarthritis Physical activity Care Pathway (OA-PCP).MethodsThis was a single group pilot study involving 60 participants with symptomatic, physician diagnosed knee or hip OA, recruited from primary care clinics. Participants self-reported completing less than 150 min per week of moderate-to-vigorous physical activity (MVPA) at baseline. The 3-month OA-PCP intervention involved 3 physical activity (PA) coaching calls (focused on goal setting), three check-in emails and linkage with community-based or online resources to support PA. Efficacy outcomes were collected at baseline and 4-month follow-up. The primary efficacy outcome was minutes of MVPA, assessed via accelerometer. Secondary outcomes included minutes of light intensity activity, sedentary minutes, step counts, and Western Ontario and McMaster Universities (WOMAC) pain and function subscales. Participants were also asked to rate the helpfulness of the OA-PCP intervention on a scale of 0–10. Differences in efficacy outcomes between baseline and 4-month follow-up were assessed using paired t-tests.ResultsAmong participants beginning the study, 88% completed follow-up assessments and ≥ 90% completed each of the intervention calls. Average daily minutes of MVPA was 8.0 at baseline (standard deviation (SD) = 9.9) and 8.9 at follow-up (SD = 12.1, p = 0.515). There were no statistically significant changes in light intensity activity, sedentary time or step counts. The mean WOMAC pain score improved from 8.1 (SD = 3.6) at baseline to 6.2 (SD = 3.8) at follow-up (p < 0.001); the mean WOMAC function score improved from 26.2 (SD = 13.2) to 20.2 (SD = 12.5; p < 0.001). The mean rating of helpfulness was 7.6 (SD = 2.5).ConclusionsResults supported the feasibility and acceptability of the study, and participants reported clinically relevant improvements in pain and function. PA metrics did not improve substantially. Based on these results and participant feedback, modifications including enhanced self-monitoring are being made to increase the impact of the OA-PCP intervention on PA behavior.Trial registrationNCT03780400, December 19, 2018.
Highlights
To obtain information on feasibility and acceptability, as well as preliminary data on efficacy, of an Osteoarthritis Physical activity Care Pathway (OA-PCP)
There is some evidence for the efficacy of primary care-based Physical activity (PA) interventions [11,12,13,14], none of these studies have focused on patients with hip and/or knee OA, who face specific challenges such as pain, fatigue, and functional limitations
This study collected preliminary data on an intervention to enhance to PA among individuals with OA, designed for delivery in a primary care setting
Summary
To obtain information on feasibility and acceptability, as well as preliminary data on efficacy, of an Osteoarthritis Physical activity Care Pathway (OA-PCP). There have been many trials of different PA and exercise-based interventions for knee OA, with clear evidence of improved pain, function and other outcomes when patients engage in these activities [6, 7]. These interventions often involve multiple in-person sessions and may not be accessible to many individuals because of program availability in their geographic area, costs, or scheduling. There is some evidence for the efficacy of primary care-based PA interventions [11,12,13,14], none of these studies have focused on patients with hip and/or knee OA, who face specific challenges such as pain, fatigue, and functional limitations. There remains a need for primary care-based PA interventions that are effective and scalable and feasible for health systems to maintain in the long term
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