Interim analysis: An interdisciplinary team approach in facilitating weight reduction and improving function for people with knee or hip osteoarthritis. The Osteoarthritis Chronic Care Program at Royal North Shore Hospital

Abstract

Aim Interim analysis of the Osteoarthritis Chronic Care Program at the Royal North Shore Hospital was conducted in order to determine (i) effectiveness of programme to facilitate reductions in weight and waist circumference and improvements in pain, function and osteoarthritis‐related outcomes and (ii) whether reductions in weight or waist circumference predict pain, functional and osteoarthritis‐related outcomes. Methods Participants with knee or hip osteoarthritis at baseline (n = 265), weeks 12 (n = 164) and 26 (n = 88) were followed. Primary outcomes were weight and waist circumference. Secondary outcomes included visual analogue scale for pain, timed up and go, 6‐minute walk test, knee injury/hip dysfunction and osteoarthritis outcome score. Results Mean absolute and percent weight loss, waist circumference and body mass index significantly reduced from baseline at both 12 and 26 weeks. Improvements in pain (P < 0.001), timed up and go (P < 0.001) and 6‐minute walk test (P < 0.001) were statistically significant in participants with knee osteoarthritis; however, only improvements in timed up and go and 6‐minute walk test were clinically relevant. Weight was not associated with any secondary outcomes except knee injury and osteoarthritis outcome score pain subscale at 12 weeks. Participants with knee osteoarthritis on average experienced 0.96 cm less pain on the visual analogue scale and walked 25.7 m more in the 6‐minute walk test than participants with hip osteoarthritis at 12 weeks which was statistically significant. Conclusions The programme assisted participants in promoting weight loss and those with knee osteoarthritis improved clinically in mobility and walking capacity by 26 weeks. Complete data set is required to validate these findings.

evidence-informed model of care for people with lower limb osteoarthritis in New Zealand

“…Physiotherapists can manage many people with musculoskeletal conditions in the primary care setting, and patients have high confidence in information, assessment and management provided by physiotherapists (Desmeules et al, 2012;Ludvigsson & Enthoven, 2012). Physiotherapy-led OA programmes have resulted in improved patient outcomes (in terms of pain, function, and weight loss) as well as reducing the need for GP visits and the demand for joint replacement surgery (Claes et al, 2015;Deslauriers et al, 2017;Dziedzic et al, 2018;Hay et al, 2006;Ludvigsson & Enthoven, 2012;Svege et al, 2015;Teoh et al, 2017). Currently, physiotherapists in Australia and Sweden are involved as primary care leaders in models of care for people with OA (Hunter et al, 2018;Jönsson et al, 2019).…”

Outcomes and Characteristics of Interdisciplinary Self-Management Interventions for Older Adults Living with Chronic Pain: Insights from a Scoping Review

“…The 66 articles selected for this scoping review included 61 quantitative studies [33][34][35][36][37][38][40][41][42][43][44][45][46][47][48][49][50][51][52][53][55][56][57][58][59][60][61][62][63][64][65][66][68][69][70][71][72][73][75][76][77][78][79][80][82][83][84][85][86][87][88][89]…”

“…Most programs were based on the cognitive-behavioral (n = 18) [33,36,39,40,44,[46][47][48][49]51,54,56,59,63,66,68,71,75,87,88,92] or biopsychosocial (n = 12) models [35][36][37]39,41,42,72,73,75,78,79,[83][84][85][93][94][95][96][97]. Some interventions were based on the patient-centered care model (n = 3) [38,58,80] or the multimodal approach (n = 2) [82,86]. Less frequently, programs were based on the chronic disease self-management model (n = 1) [38], the social cognitive theory (n = 1) [57], a community-based model of care (n = 1) [81], th...…”

“…Some interventions were based on the patient-centered care model (n = 3) [38,58,80] or the multimodal approach (n = 2) [82,86]. Less frequently, programs were based on the chronic disease self-management model (n = 1) [38], the social cognitive theory (n = 1) [57], a community-based model of care (n = 1) [81], the osteoarthritis research society guidelines [81], or a spiritual-based approach (n = 1) [64]. Sixteen programs did not describe the model or theory underlying the treatment [34,43,45,50,52,53,61,62,65,67,70,76,77,90,91,98].…”

“…Participants in all programs (n = 5) had individualized appointments with a physiotherapist. The follow-up with the physiotherapist included strength and mobility exercises in four studies [38,80,87,97] and instructions on physical activity in two studies [80,82]. In the study by Nishie et al 2018 [97], the focus of the self-management treatment was the performance of exercises at home.…”