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- Bendrik, Regina
(författare)
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Aspects of improving and maintaining physical activity in patients with hip or knee osteoarthritis
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: This thesis aims to enhance knowledge of how people with osteoarthritis should be managed and supported in order to increase and maintain physical activity in the long-term. Method: Study I and study II was based on a randomised controlled study (RCT) including 141 osteoarthritis patients. The short and long-term effect of an individualised physical activity on prescription intervention compared with individualised advice about physical activity were evaluated. The primary outcome was physical activity and secondary outcomes were fitness/performance, pain and quality of life, evaluated at 6, 12 and 24 months. In Study III, 7-day diaries were evaluated regarding which forms of physical activity i.e. walking, swimming, cycling, gardening etc. the patients chose themselves and maintained after one and two years. In addition were evaluated, which category these activities belonged to: aerobic, muscle strength, mind-body or everyday activity, and whether there were differences in characteristic of the patients in the different forms. In study IV responsiveness of function, how well instruments captured an improvement, one year after a physical activity intervention was measured. Two unilateral performance-based tests were compared with a bilateral performance-based test and with questionnaires about function. Results: The RCT provided no evidence that individualised physical activity on prescription differ from individualised advice on physical activity in improving short and long-term physical activity, function, pain and quality of life (Study I and II). Walking was the form of physical activity performed most frequently and best maintained after 12 and 24 months. Walking were preferred by women, older individuals and individuals with weak legs while men also preferred everyday activity and cycling. Few patients preferred strength training (Study III). The maximal step-up test (one-leg testing) was more responsive to change in physical function (SMD effect size 0.57) compare to the bilateral 30-second chair-stand test (0.48) (Study IV). Conclusion: There is still absence of evidence for any particular physical activity intervention to effectively increase physical activity in the long-term in osteoarthritis patients. Individual counselling with support to choose preferred physical activities that are easy to perform in daily life may be a beneficial approach for long-term maintenance.
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| 2. |
- Bendrik, Regina, et al.
(författare)
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Follow-up of individualised physical activity on prescription and individualised advice in patients with hip or knee osteoarthritis : A randomised controlled trial.
- 2024
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Ingår i: Clinical Rehabilitation. - : Sage Publications. - 0269-2155 .- 1477-0873. ; 38:6, s. 770-782
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Compare the long-term effects of two different individualised physical activity interventions in hip or knee osteoarthritis patients.DESIGN: Randomised, assessor-blinded, controlled trial.SETTING: Primary care.SUBJECTS: Patients with clinically verified hip or knee osteoarthritis, <150 min/week with moderate or vigorous physical activity, aged 40-74.INTERVENTION: The advice group (n = 69) received a 1-h information and goalsetting session for individualised physical activity. The prescription group (n = 72) received information, goalsetting, individualised written prescription, self-monitoring, and four follow-ups.MAIN MEASURES: Physical activity, physical function, pain and quality of life at baseline, 6, 12 and 24 months.RESULTS: There were only minor differences in outcomes between the two groups. For self-reported physical activity, the advice group had improved from a mean of 102 (95% CI 74-130) minutes/week at baseline to 214 (95% CI 183-245) minutes/week at 24 months, while the prescription group had improved from 130 (95% CI 103-157) to 176 (95% CI 145-207) minutes/week (p = 0.01 between groups). Number of steps/day decreased by -514 (95% CI -567-462) steps from baseline to 24 months in the advice group, and the decrease in the prescription group was -852 (95% CI -900-804) steps (p = 0.415 between groups). Pain (HOOS/KOOS) in the advice group had improved by 7.9 points (95% CI 7.5-8.2) and in the prescription group by 14.7 points (95% CI 14.3-15.1) from baseline to 24 months (p = 0.024 between groups).CONCLUSIONS: There is no evidence that individualised physical activity on prescription differs from individualised advice in improving long-term effects in patients with hip or knee osteoarthritis.
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| 5. |
- Bendrik, Regina, et al.
(författare)
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One leg testing in hip and knee osteoarthritis : A comparison with a two-leg oriented functional outcome measure and self-reported functional measures.
- 2024
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Ingår i: Osteoarthritis and Cartilage. - : Elsevier. - 1063-4584 .- 1522-9653. ; 32:7, s. 937-942
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare the responsiveness of two unilateral lower-limb performance-based tests, the one-leg rise test and the maximal step-up test, with the bilateral 30-second chair-stand test and the self-reported measure of physical function (HOOS/KOOS). Specific aims were to evaluate responsiveness, floor/ceiling effect and association between the instruments.METHOD: Data was included from 111 participants, mean age 61.3 years (8.3), with clinically verified hip or knee osteoarthritis, who reported less than 150 minutes/week of moderate or vigorous intensity physical activity. Responsiveness, how well the instruments captured improvements, was measured as Cohen's standardised mean difference for effect size, and was assessed from baseline to 12 months following a physical activity intervention. Other assessments were floor and ceiling effects, and correlations between tests.RESULTS: The maximal step-up test had an effect size of 0.57 (95% CI 0.37, 0.77), the 30-second chair-stand 0.48 (95% CI 0.29, 0.68) and the one-leg rise test 0.12 (95% CI 0.60, 0.31). The one-leg rise test had a floor effect as 72% of the participants scored zero at baseline and 63% at 12 months. The correlation between performance-based tests and questionnaires was considered to be minor (r = 0.188 to 0.226) (p = 0.018 to 0.048).CONCLUSION: The unilateral maximal step-up test seems more responsive to change in physical function compared to the bilateral 30-second chair-stand test, although the tests did not differ statistically in effect size. The maximal step-up test provides specific information about each leg for the individual and allows for comparison between the legs.
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| 6. |
- Bendrik, Regina, et al.
(författare)
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Physical activity on prescription in patients with hip or knee osteoarthritis : A randomized controlled trial.
- 2021
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Ingår i: Clinical Rehabilitation. - : Sage Publications. - 0269-2155 .- 1477-0873. ; 35:10, s. 1465-1477
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate whether physical activity on prescription, comprising five sessions, was more effective in increasing physical activity than a one-hour advice session after six months.DESIGN: Randomized, assessor-blinded, controlled trial.SETTING: Primary care.SUBJECTS: Patients with clinically verified osteoarthritis of the hip or knee who undertook less than 150 minute/week of moderate physical activity, and were aged 40-74 years.INTERVENTIONS: The advice group (n = 69) received a one-hour session with individually tailored advice about physical activity. The physical activity on prescription group (n = 72) received individually tailored physical activity recommendations with written prescription, and four follow-ups during six months.MAIN MEASURES: Patients were assessed at baseline and six months: physical activity (accelerometer, questionnaires); fitness (six-minute walk test, 30-second chair-stand test, maximal step-up test, one-leg rise test); pain after walking (VAS); symptoms (HOOS/KOOS); and health-related quality of life (EQ-5D).RESULTS: One hundred four patients had knee osteoarthritis, 102 were women, and mean age was 60.3 ± 8.3 years. Pain after walking decreased significantly more in the prescription group, from VAS 31 ± 22 to 18 ± 23. There was no other between groups difference. Both groups increased self-reported activity minutes significantly, from 105 (95% CI 75-120) to 165 (95% CI 135-218) minute/week in the prescription group versus 75 (95% CI 75-105) to 150 (95% CI 120-225) in the advice group. Also symptoms and quality of life improved significantly in both groups.CONCLUSION: Individually tailored physical activity with written prescription and four follow-ups does not materially improve physical activity level more than advice about osteoarthritis and physical activity.TRIAL REGISTRATION: ClinicalTrials.gov (NCT02387034).
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| 9. |
- Nyberg, Lillemor, et al.
(författare)
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Primärvården har en nyckelroll för tidig diagnos och uppföljning : [Primary health care plays a key role in early diagnosis and follow-up].
- 2014
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 111:21, s. 939-942
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Tidskriftsartikel (refereegranskat)abstract
- Tidig klinisk diagnos av den kro-niska sjukdomen artros i knä och i höft är viktig för att tidigt kunna förebygga och behandla smärta, försämrad funktion och övervikt.Fysioterapeuten ställer klinisk diagnos enligt de nationella rikt-linjerna, prioriterar information (artrosskola), leder långvarig trä-ning och lär ut självtest för styrka och kondition samt ordinerar fysisk aktivitet på recept (FaR) livslångt.I dag rekommenderas all vård-personal att använda ett enkelt test, 30-sekunders sitt och stå-test, för bedömning av den aktuella benstyrkan.Riskfaktorer för hjärt–kärlsjuk-dom är viktiga att behandla. Ar-tros minskar patientens fysiska aktivitet, därför ökar risken för förtida död. Ökad kunskap om sarkopeni visar på metabola konsekvenser.
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