La Trobe Sport & Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia; Discipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia.
La Trobe University School of Psychology and Public Health, Bundoora, Australia.
Braz J Phys Ther. 2024 Sep-Oct;28(5):101113. doi: 10.1016/j.bjpt.2024.101113. Epub 2024 Sep 5.
A mixed methods study which aimed to evaluate the influence of Good Life with osteoArthritis Denmark (GLA:D®) on physical activity participation, including perceived capability, barriers, and facilitators in people with knee osteoarthritis.
Quantify changes in physical activity participation at 3- and 12-months for people with knee osteoarthritis who participated in an education and exercise-therapy program (GLA:D®).
A mixed-methods study involving 44 participants with knee osteoarthritis who completed GLA:D®. Guided by the Theoretical Domains Framework, 19 were interviewed, with transcripts analysed using reflexive thematic analysis. University of California Los Angeles physical activity scores were dichotomised as 'more' (≥7) or 'less' active (≤6), and compared between baseline and 3- and 12-months using McNemar's test. Motivation and confidence to exercise (0-10 scale); fear of knee joint damage with exercise (yes/no); and Knee Osteoarthritis Outcome Scores (KOOS) were evaluated.
Four overarching themes were identified: prior to GLA:D® 1) fear of knee joint damage, and scarcity of exercise and physical activity information prior to GLA:D®; and following GLA:D® 2) varied exercise-therapy and physical activity participation; 3) facilitators including reduced fear of knee damage, increased confidence, routine, strategies, and support; and 4) ongoing barriers including persistent knee pain, comorbidities, cost, and lack of opportunity and motivation. There was no difference in the proportion of 'more' active participants between baseline (41%) and at 3-months (37%, p = 0.774) or 12-months (35%, p = 0.375). The proportion with fear of damage reduced from baseline (50%) to 3-months (5%) and 12-months (21%). Self-reported motivation (9.1/10) and confidence (9.1/10) to exercise at 3-months were high, and all KOOS subscales improved from baseline to 3-months (effect sizes = 0.41-0.58) and 12-months (effect sizes = 0.29-0.66).
Varied and often inadequate physical activity participation following GLA:D® indicates more targeted interventions to address ongoing barriers may be required.
本混合方法研究旨在评估丹麦关节炎生活质量（GLA:D®）对膝关节骨关节炎患者身体活动参与度的影响，包括感知能力、障碍和促进因素。
量化参加教育和运动疗法计划（GLA:D®）的膝关节骨关节炎患者在 3 个月和 12 个月时身体活动参与度的变化。
本混合方法研究纳入了 44 名膝关节骨关节炎患者，他们完成了 GLA:D®。研究人员根据理论领域框架对 19 名参与者进行了访谈，使用反思性主题分析对转录本进行了分析。加州大学洛杉矶分校身体活动评分采用二分法（“更多”[≥7]或“更少”[≤6]），并使用 McNemar 检验比较基线时和 3 个月和 12 个月时的评分。评估了运动动机和信心（0-10 分）、对膝关节损伤的恐惧（是/否）和膝关节骨关节炎结局评分（KOOS）。
确定了四个总体主题：1）在接受 GLA:D®之前：①对膝关节损伤的恐惧和缺乏运动和身体活动信息；以及在接受 GLA:D®之后：②运动疗法和身体活动参与的多样性；③促进因素包括减少对膝关节损伤的恐惧、增强信心、养成习惯、使用策略和获得支持；以及④持续存在的障碍，包括持续的膝关节疼痛、合并症、成本、缺乏机会和动机。在基线时（41%）和 3 个月时（37%，p=0.774）或 12 个月时（35%，p=0.375），“更活跃”参与者的比例没有差异。对损伤的恐惧比例从基线时（50%）下降到 3 个月时（5%）和 12 个月时（21%）。自我报告的运动动机（9.1/10）和信心（9.1/10）在 3 个月时较高，所有 KOOS 亚量表均从基线改善到 3 个月（效应大小=0.41-0.58）和 12 个月（效应大小=0.29-0.66）。
接受 GLA:D®后身体活动参与度差异较大且往往不足，表明可能需要更有针对性的干预措施来解决持续存在的障碍。
