Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
BMC Musculoskelet Disord. 2019 Sep 14;20(1):428. doi: 10.1186/s12891-019-2801-z.
Knee osteoarthritis (OA) is a highly prevalent condition. People with knee OA often have other co-morbidities such as obesity. Exercise is advocated in all clinical guidelines for the management of knee OA. It is often undertaken as a home-based program, initially prescribed by a physiotherapist or other qualified health care provider. However, adherence to home-based exercise is often poor, limiting its ability to meaningfully change clinical symptoms of pain and/or physical function. While the efficacy of short message services (SMS) to promote adherence to a range of health behaviours has been demonstrated, its ability to promote home exercise adherence in people with knee OA has not been specifically evaluated. Hence, this trial is investigating whether the addition of an SMS intervention to support adherence to prescribed home-based exercise is more effective than no SMS on self-reported measures of exercise adherence.
We are conducting a two-arm parallel-design, assessor-and participant-blinded randomised controlled trial (ADHERE) in people with knee OA and obesity. The trial is enrolling participants exiting from another randomised controlled trial, the TARGET trial, where participants are prescribed a 12-week home-based exercise program (either weight bearing functional exercise or non-weight bearing quadriceps strengthening exercise) for their knee by a physiotherapist and seen five times over the 12 weeks for monitoring and supervision. Following completion of outcome measures for the TARGET trial, participants are immediately enrolled into the ADHERE trial. Participants are asked to continue their prescribed home exercise program unsupervised three times a week for 24-weeks and are randomly allocated to receive a behaviour change theory-informed SMS intervention to support home exercise adherence or to have no SMS intervention. Outcomes are measured at baseline and 24-weeks. Primary outcomes are self-reported adherence measures. Secondary outcomes include self-reported measures of knee pain, physical function, quality-of-life, physical activity, self-efficacy, kinesiophobia, pain catastrophising, participant-perceived global change and an additional adherence measure.
Findings will provide new information into the potential of SMS to improve longer-term exercise adherence and ultimately enhance exercise outcomes in knee OA.
Prospectively registered with the Australian New Zealand Clinical Trials Registry. Reference: ACTR N12617001243303 Date/version: August 2019/two.
膝骨关节炎（OA）是一种高度流行的疾病。患有膝骨关节炎的人通常还有其他合并症，如肥胖。所有临床指南都主张对膝骨关节炎进行运动治疗。运动通常作为家庭锻炼计划来实施，最初由物理治疗师或其他合格的医疗保健提供者开具。然而，家庭锻炼的坚持率往往较低，限制了其改变疼痛和/或身体功能等临床症状的能力。虽然短信息服务（SMS）在促进一系列健康行为方面的效果已得到证实，但它在促进膝骨关节炎患者家庭锻炼的坚持方面的效果尚未得到专门评估。因此，本试验旨在研究在支持遵守规定的家庭锻炼方面，SMS 干预的附加作用是否比没有 SMS 更有效，这是基于自我报告的锻炼坚持度测量结果来评估的。
我们正在开展一项由两项双臂平行设计、评估者和参与者双盲的随机对照试验（ADHERE），研究对象为膝骨关节炎合并肥胖的患者。该试验正在招募从另一项随机对照试验 TARGET 试验中退出的参与者，在 TARGET 试验中，物理治疗师为参与者开出为期 12 周的家庭锻炼计划（负重功能锻炼或非负重股四头肌强化锻炼），并在 12 周内进行 5 次监测和监督。在 TARGET 试验的结果测量完成后，参与者立即被纳入 ADHERE 试验。要求参与者继续进行未经监督的每周三次、为期 24 周的规定家庭锻炼计划，并随机分配接受行为改变理论指导的 SMS 干预以支持家庭锻炼坚持，或不接受 SMS 干预。结果在基线和 24 周时进行测量。主要结果是自我报告的坚持度测量结果。次要结果包括自我报告的膝关节疼痛、身体功能、生活质量、体力活动、自我效能、运动恐惧、疼痛灾难化、参与者感知的整体变化以及额外的坚持度测量结果。
研究结果将提供有关 SMS 提高长期锻炼坚持度并最终增强膝骨关节炎患者锻炼效果的潜在信息。
前瞻性注册于澳大利亚和新西兰临床试验注册中心。参考号：ACTRN12617001243303 日期/版本：2019 年 8 月/第二版。
