The AktiWeb study: feasibility of a web-based exercise program delivered by a patient organisation to patients with hip and/or knee osteoarthritis

Abstract

Background Patient organisations may be an under-utilised resource in follow-up of patients requiring long-term exercise as part of their disease management. The purpose of this study was to explore the feasibility of a web-based exercise program delivered by a patient organisation to patients with hip and/or knee osteoarthritis (OA). Methods In this pre–post feasibility study, patients aged 40–80 years with hip and/or knee OA were recruited from Diakonhjemmet Hospital. The 12-week intervention was delivered through a patient organisation’s digital platform. Feasibility was evaluated by proportion of eligible patients enrolled, proportion of enrolled patients who provided valid accelerometer data at baseline, and proportion completing the cardiorespiratory exercise test according to protocol at baseline and completed follow-up assessments. Patient acceptability was evaluated for website usability, satisfaction with the initial exercise level and comprehensibility of the exercise program. Change in clinical outcomes were assessed for physical activity, cardiorespiratory fitness and patient-reported variables. Results In total, 49 eligible patients were identified and 35 were enrolled. Thirty (86%) of these attended baseline assessments and provided valid accelerometer data and 18 (51%) completed the maximal cardiorespiratory exercise test according to protocol. Twenty-two (63%) patients completed the follow-up questionnaire, and they rated the website usability as ‘acceptable’ [median 77.5 out of 100 (IQR 56.9, 85.6)], 19 (86%) reported that the initial exercise level was ‘just right’ and 18 (82%) that the exercise program was ‘very easy’ or ’quite easy’ to comprehend. Improvement in both moderate to vigorous physical activity (mean change 16.4 min/day; 95% CI 6.9 to 25.9) and cardiorespiratory fitness, VO2peak (mean change 1.83 ml/kg/min; 95% CI 0.29 to 3.36) were found in a subgroup of 8 patients completing these tests. Across all patient-reported outcomes 24–52% of the patients had a meaningful improvement (n = 22). Conclusion A web-based exercise program delivered by a patient organisation was found to be feasible and acceptable in patients with hip and/or knee OA. Trial registration ClinicalTrials.gov, NCT04084834 (registered 10 September 2019). The Regional Committee for Medical and Health Research Ethics south-east, 2018/2198. URL: Prosjekt #632074 - Aktiv med web-basert støtte. - Cristin (registered 7 June 2019).

Adherence to a Web-based Exercise Programme: A Feasibility Study Among Patients with Hip or Knee Osteoarthritis

“…The data are collected in a study assessing feasibility of a web-based aerobic exercise programme for patients with OA ( 8 ). The exercise programme and methods of delivery are described in detail elsewhere ( 8 ).…”

“…The data are collected in a study assessing feasibility of a web-based aerobic exercise programme for patients with OA ( 8 ). The exercise programme and methods of delivery are described in detail elsewhere ( 8 ). Patients aged 40–80 years, referred to Diakonhjemmet Hospital, Oslo, Norway for surgical consultation due to hip or knee OA, were eligible if not considered candidates for surgery.…”

“…The patients were asked to wear the accelerometer during all waking hours for 7 consecutive days (except during water-based activities). A valid recording is referred to as at least 4 days with minimum 10 h of recording per day ( 8 ). In addition, baseline assessments included a maximal modified Balke test ( n = 20) or a submaximal single-stage test ( n = 9) to assess cardiorespiratory fitness (VO 2peak/max ) ( 8 ), and questions about physical activity habits and pain during physical activity, which were used to determine each patient’s initial exercise level (described elsewhere ( 8 )).…”

“…The 12-week web-based programme was developed in close collaboration with a patient organization (Norwegian Rheumatic Association, Oslo, Norway) and was designed as a progressive aerobic exercise programme comprising 3 sessions per week (2 interval and 1 light to moderate intensity session) across 5 different exercise levels. For each increment in exercise level, the weekly exercise dosage was increased (duration and/or intensity using the Borg Rating of Perceived Exertion ranging from 6 (no exertion) to 20 (maximal exertion) ( 9 ) as guidance ( 8 ). The exercise level for the subsequent week was determined by the project manager based on number of sessions completed and reported barriers for not completing the exercise programme (barriers selected from a predefined list ( 10 ) and reported in the electronic exercise diary).…”

Patient Organizations’ Digital Adaptations to the COVID-19 Pandemic: A Scoping Review (Preprint)

“…Before the pandemic, research indicated that the level of digitalization among POs varied widely. While many relied primarily on basic digital communication tools such as websites, email, and social media, others embraced advanced technologies and developed interactive platforms, mobile applications, or electronic patient databases to enhance the use of digital patient data for research [14][15][16]. These differences in digitalization levels may be linked to the organizational characteristics described above, as well as additional factors such as the digital literacy of PO leadership and members and their demographic profile [14].…”