Department of Physiotherapy, University of Melbourne, Centre for Health, Exercise and Sports Medicine, Carlton, Australia.
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
J Med Internet Res. 2020 Sep 28;22(9):e21749. doi: 10.2196/21749.
Exercise is a core recommended treatment for knee osteoarthritis (OA), yet adherence declines, particularly following cessation of clinician supervision.
This study aims to evaluate whether a 24-week SMS intervention improves adherence to unsupervised home exercise in people with knee OA and obesity compared with no SMS.
A two-group superiority randomized controlled trial was performed in a community setting. Participants were people aged 50 years with knee OA and BMI ≥30 kg/m who had undertaken a 12-week physiotherapist-supervised exercise program as part of a preceding clinical trial. Both groups were asked to continue their home exercise program unsupervised three times per week for 24 weeks and were randomly allocated to a behavior change theory-informed, automated, semi-interactive SMS intervention addressing exercise barriers and facilitators or to control (no SMS). Primary outcomes were self-reported home exercise adherence at 24 weeks measured by the Exercise Adherence Rating Scale (EARS) Section B (0-24, higher number indicating greater adherence) and the number of days exercised in the past week (0-3). Secondary outcomes included self-rated adherence (numeric rating scale), knee pain, physical function, quality of life, global change, physical activity, self-efficacy, pain catastrophizing, and kinesiophobia.
A total of 110 participants (56 SMS group and 54 no SMS) were enrolled and 99 (90.0%) completed both primary outcomes (48/56, 86% SMS group and 51/54, 94% no SMS). At 24 weeks, the SMS group reported higher EARS scores (mean 16.5, SD 6.5 vs mean 13.3, SD 7.0; mean difference 3.1, 95% CI 0.8-5.5; P=.01) and more days exercised in the past week (mean 1.8, SD 1.2 vs mean 1.3, SD 1.2; mean difference 0.6, 95% CI 0.2-1.0; P=.01) than the control group. There was no evidence of between-group differences in secondary outcomes.
An SMS program increased self-reported adherence to unsupervised home exercise in people with knee OA and obesity, although this did not translate into improved clinical outcomes.
Australian New Zealand Clinical Trials Registry 12617001243303; https://tinyurl.com/y2ud7on5.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12891-019-2801-z.
运动是治疗膝骨关节炎（OA）的核心推荐治疗方法，但依从性下降，尤其是在停止临床医生监督后。
本研究旨在评估 24 周短信干预是否比无短信干预更能提高膝 OA 合并肥胖人群的无监督家庭运动依从性。
在社区环境中进行了一项 2 组优势随机对照试验。参与者为年龄在 50 岁及以上、膝关节 OA 和 BMI≥30kg/m2 的人群，他们在之前的临床试验中接受了 12 周的物理治疗师监督的运动计划。两组均被要求继续每周进行三次无监督的家庭运动计划，为期 24 周，并随机分配到行为改变理论指导的自动化半交互式短信干预组，该干预组针对运动障碍和促进因素，或对照组（无短信）。主要结局指标为使用锻炼依从性评定量表（EARS）B 部分（0-24，分数越高表示依从性越高）和过去一周锻炼天数（0-3）在 24 周时自我报告的家庭锻炼依从性。次要结局指标包括自我报告的依从性（数字评分量表）、膝关节疼痛、身体功能、生活质量、整体变化、身体活动、自我效能、疼痛灾难化和运动恐惧。
共纳入 110 名参与者（SMS 组 56 名，无 SMS 组 54 名），其中 99 名（90.0%）完成了两项主要结局指标（SMS 组 48/56，86%；无 SMS 组 51/54，94%）。24 周时，SMS 组报告的 EARS 评分更高（均值 16.5，SD 6.5 比均值 13.3，SD 7.0；平均差异 3.1，95%CI 0.8-5.5；P=.01），过去一周的锻炼天数也更多（均值 1.8，SD 1.2 比均值 1.3，SD 1.2；平均差异 0.6，95%CI 0.2-1.0；P=.01），高于对照组。两组间次要结局无差异证据。
短信计划增加了膝骨关节炎和肥胖患者对无监督家庭运动的自我报告依从性，但这并未转化为改善的临床结局。
澳大利亚新西兰临床试验注册中心 12617001243303；https://tinyurl.com/y2ud7on5。
国际注册报告标识符（IRRID）：RR2-10.1186/s12891-019-2801-z。
