TY - JOUR
T1 - Prognostic Factors for Health Outcomes After Exercise Therapy and Education in Individuals With Knee and Hip Osteoarthritis With or Without Comorbidities
T2 - A Study of 37,576 Patients Treated in Primary Care
AU - Pihl, Kenneth
AU - Roos, Ewa M
AU - Taylor, Rod S
AU - Grønne, Dorte T
AU - Skou, Søren T
N1 - Supported by the European Research Council under the European Union's Horizon 2020 Research and Innovation Programme (project MOBILIZE; grant agreement no. 801790), Næstved, Slagelse, and Ringsted Hospitals’ Research Fund, and the Association of Danish Physiotherapists Research Fund. The start-up phase of GLA:D was partly funded by the Danish Physiotherapy Association's Fund for Research, Education and Practice Development, the Danish Rheumatism Association, and the Physiotherapy Practice Foundation. Dr. Skou is recipient of a program grant from Region Zealand (Exercise First) and an ongoing grant from the European Research Council under the European Union's Horizon 2020 Research and Innovation Programme (project ESCAPE; grant agreement no. 945377).
PY - 2022/11
Y1 - 2022/11
N2 - Objective: To identify prognostic factors for health outcomes following an 8-week supervised exercise therapy and education program for individuals with knee and hip osteoarthritis (OA) alone or with concomitant hypertension, heart or respiratory disease, diabetes mellitus, or depression. Methods: We included individuals with knee and/or hip OA from the Good Life With OsteoArthritis in Denmark (GLA:D) program. GLA:D consists of 2 patient education sessions and 12 supervised exercise therapy sessions. Before GLA:D, participants self-reported any comorbidities and were categorized into 8 comorbidity groups. Twenty-one potential prognostic factors (demographic information, clinical data, and performance-based physical function) gathered from participants and clinicians before the program were included. Outcomes were physical function using the 40-meter Fast-Paced Walk Test (FPWT), health-related quality of life using the 5-level EuroQol 5-domain (EQ-5D-5L) index score, and pain intensity using a visual analog scale (VAS; range 0–100) assessed before and immediately after the GLA:D program. Within each comorbidity group, associations of prognostic factors with outcomes were estimated using multivariable linear regression. Results: Data from 35,496 (40-meter FPWT) and 37,576 (EQ-5D-5L and VAS) participants were included in the analyses. Clinically relevant associations were demonstrated between age, self-efficacy, self-rated health, and pain intensity and change in 40-meter FPWT, EQ-5D-5L, or VAS scores across comorbidity groups. Furthermore, anxiety, education, physical function, and smoking were associated with outcomes among subgroups having depression or diabetes mellitus in addition to OA. Conclusion: Age, self-efficacy, self-rated health, and pain intensity may be prognostic of change in health outcomes following an 8-week exercise therapy and patient education program for individuals with OA, irrespective of comorbidities.
AB - Objective: To identify prognostic factors for health outcomes following an 8-week supervised exercise therapy and education program for individuals with knee and hip osteoarthritis (OA) alone or with concomitant hypertension, heart or respiratory disease, diabetes mellitus, or depression. Methods: We included individuals with knee and/or hip OA from the Good Life With OsteoArthritis in Denmark (GLA:D) program. GLA:D consists of 2 patient education sessions and 12 supervised exercise therapy sessions. Before GLA:D, participants self-reported any comorbidities and were categorized into 8 comorbidity groups. Twenty-one potential prognostic factors (demographic information, clinical data, and performance-based physical function) gathered from participants and clinicians before the program were included. Outcomes were physical function using the 40-meter Fast-Paced Walk Test (FPWT), health-related quality of life using the 5-level EuroQol 5-domain (EQ-5D-5L) index score, and pain intensity using a visual analog scale (VAS; range 0–100) assessed before and immediately after the GLA:D program. Within each comorbidity group, associations of prognostic factors with outcomes were estimated using multivariable linear regression. Results: Data from 35,496 (40-meter FPWT) and 37,576 (EQ-5D-5L and VAS) participants were included in the analyses. Clinically relevant associations were demonstrated between age, self-efficacy, self-rated health, and pain intensity and change in 40-meter FPWT, EQ-5D-5L, or VAS scores across comorbidity groups. Furthermore, anxiety, education, physical function, and smoking were associated with outcomes among subgroups having depression or diabetes mellitus in addition to OA. Conclusion: Age, self-efficacy, self-rated health, and pain intensity may be prognostic of change in health outcomes following an 8-week exercise therapy and patient education program for individuals with OA, irrespective of comorbidities.
U2 - 10.1002/acr.24722
DO - 10.1002/acr.24722
M3 - Journal article
C2 - 34085408
SN - 2151-464X
VL - 74
SP - 1866
EP - 1878
JO - Arthritis Care & Research
JF - Arthritis Care & Research
IS - 11
ER -