Cross-cultural Adaptation and Implementation of Good Life with Osteoarthritis in Denmark (GLA:DTM): group education and exercise for hip and knee osteoarthritis is feasible in Canada

Aileen M. Davis, Deborah Kennedy, Rosalind Wong, Susan Robarts, Søren T. Skou, Rhona McGlasson, Linda C. Li, Ewa Roos

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Abstract (248 words)Objective Adapt and evaluate the feasibility of implementing Good Life with osteoArthritis in Denmark (GLA:DTM) in Canada for people with mild to severe hip/knee osteoarthritis. Methods Patients triaged to non-surgical management participated in two education sessions and 12 supervised, neuromuscular exercise classes. We used the RE-AIM implementation framework evaluating outcomes of Reach, Effectiveness/Efficacy, Adoption, Implementation and Maintenance. Patients completed surveys pre-program and at 3 months follow-up. Program fidelity was evaluated at 4 observations against a priori criteria. We conducted semi-structured interviews with therapists post-program. Results 72 patients consented to participate, 59 started the program and one withdrew on physician advice. The remaining 58 provided follow-up data. Mean age was 67 years; 78% were female and 52% had BMI >25. The effect of the program was demonstrated: 40% improvement in pain with 59% achieving a clinically important improvement of >2 points on the Numeric Pain Rating scale. Statistically significant improvement also occurred in the Hip disability/Knee injury and Osteoarthritis Outcome Score subscales. 24% reported increased physical activity. Program fidelity was demonstrated with all criteria met. Therapists emphasized that rolling recruitment allowed appropriate supervision and resulted in participants encouraging each other. 99% of participants indicated they benefitted from and were satisfied with the program and 90% reported using the knowledge daily. 52% were willing to pay >$250 Cdn for the program. Conclusion GLA:DTM implementation was feasible in the Canadian context with results similar to those of >7,000 participants in Denmark. Implementation and evaluation of GLA:DTM Canada is now occurring nationally.
Original languageEnglish
JournalOsteoarthritis and Cartilage
Issue number2
Pages (from-to)211-219
Publication statusPublished - Feb 2018


  • Cross-cultural adaptation
  • Education
  • Hip and knee osteoarthritis
  • Implementation feasibility study
  • Neuromuscular exercise
  • Non-surgical management

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