Enhancing physical activity and reducing symptoms of patients with osteoarthritis of the knee: a randomized controlled trial of the PrevOP-Psychological Adherence Program

BMC Musculoskeletal Disorders

Research

Hendrikje Börst¹  Gabriele Armbrecht¹  Jan Keller²  Sally Di Maio²  Noemi Lorbeer²  Nina Knoll²  Antonia Domke²  Ralf Schwarzer³  Wolfgang Ertel⁴  Peter Martus⁵ 

[1] Centre for Muscle- and Bone Research, Department of Radiology, Charité – Universitätsmedizin Berlin, Hindenburgdamm 30, 12200, Berlin, Germany;Department of Education and Psychology, Health Psychology Division, Freie Universität Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany;Department of Education and Psychology, Health Psychology Division, Freie Universität Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany;CARE-BEH Center for Applied Research on Health Behavior and Health, SWPS University, ul. Ostrowskiego 30b, 53-238, Wrocław, Poland;Department of Traumatology and Reconstructive Surgery, Charité – Universitätsmedizin Berlin, Hindenburgdamm 30, 12200, Berlin, Germany;Institute for Clinical Epidemiology and Applied Biometry, Universitätsklinikum Tübingen, Silcherstr. 5, 72076, Tübingen, Germany;

关键词: Knee osteoarthritis;    Osteoarthritis symptoms;    Physical activity;    Accelerometer;    Planning;    Action control;    Health action process approach;    RCT;   

DOI  :  10.1186/s12891-023-06661-x

 received in 2023-02-17, accepted in 2023-06-23,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThis primary analysis evaluated the “PREVenting the impairment of primary Osteoarthritis by high-impact long-term Physical exercise regimen—Psychological Adherence Program” (PrevOP-PAP), designed to support patients with osteoarthritis of the knee (OAK) to engage in regular moderate-to-vigorous physical activity (MVPA) to reduce OAK symptoms (WOMAC scores). Theory-based on the health action process approach (HAPA), the intervention targeted volitional precursors of MVPA change: action and coping planning, maintenance and recovery self-efficacy, action control, and social network formation. We hypothesized that compared to an active control condition, increases in MVPA at the end of the 12-month intervention would translate into lower WOMAC scores at 24 months in the intervention condition.MethodsParticipants with radiographically verified moderate OAK (N = 241; 62.66% female; M(SD) = 65.60(7.61) years) were randomly assigned to the intervention (51%) or the active control condition. WOMAC scores (24 months) were the primary -, accelerometer-assessed MVPA (12 months) the key secondary outcomes. The PrevOP-PAP was a 12-month intervention with computer-assisted face-to-face and phone-based sessions designed to increase HAPA-proposed volitional precursors of MVPA change (up to 24 months; secondary outcomes). Intent-to-treat analyses included multiple regression and manifest path models.ResultsMVPA (12 months) did not mediate effects of the PrevOP-PAP on WOMAC scores (24 months). Compared to the active control condition, WOMAC scores (24 months) were lower in the intervention condition, but this effect did not remain stable in sensitivity analyses (b(SE) = -8.41(4.66), 95%-CI [-17.53; 0.71]). However, exploratory analyses revealed significantly stronger reductions in WOMAC-pain (24 months) in the intervention condition (b(SE) = -2.99(1.18), 95%-CI [-5.36; -0.63]). Groups did not differ in MVPA at 12 months (b(SE) = -3.78(3.42), 95%-CI [-10.80; 2.58]). Of the proposed precursors of MVPA change, action planning was higher in the intervention than in the control condition (24 months; b(SE) = 0.64(0.26), 95%-CI [0.14; 1.15]).ConclusionsCompared to an active control condition, the PrevOP-PAP did not produce reliable effects on WOMAC scores and none on preceding MVPA. Of the HAPA-proposed volitional precursors, only action planning was sustainably increased. Future interventions should use m-health applications to digitally support long-term changes in proposed volitional precursors of MVPA change.Trial registrationGerman Clinical Trials Register; https://drks.de/search/de/trial/DRKS00009677; also available at http://apps.who.int/trialsearch/; registration number: DRKS00009677; date of registration: 26/01/2016.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 2

Fig. 4