Use of Nondrug, Nonoperative Interventions by Community‐Dwelling People With Hip and Knee Osteoarthritis

Abstract

Objective. Guidelines recommend nondrug, nonoperative treatments as the first-line approach for hip and knee osteoarthritis (OA), yet there is limited data regarding use of these treatments in OA. This study describes the use of nondrug, nonoperative interventions in people with hip and knee OA. Methods. A convenience sample of 591 people with hip or knee OA completed a questionnaire indicating their past and/or current use of 17 nondrug, nonoperative interventions each for their hip or knee OA. Descriptive analyses, based on frequency counts and proportions, and chi-square tests described the use of each intervention in the total cohort, and within subgroups of knee and hip OA. Results. Participants were currently using a mean ؎ SD of 0.8 ؎ 0.9 of the strongly recommended interventions. Making efforts to lose weight (50%, n ‫؍‬ 294) and shoe orthoses (30%, n ‫؍‬ 175) were the most common currently used interventions. Strengthening (26%, n ‫؍‬ 152) and stretching exercises (23%, n ‫؍‬ 133) were the most common interventions that participants had tried in the past but were no longer utilizing. Of note, 12% (n ‫؍‬ 71) had never used any of the interventions. Use of 5 treatments (shoe orthoses, heat and/or cold, muscle strengthening exercises, walking aids, and transcutaneous electrical nerve stimulation) was significantly different between the hip and knee cohorts (P < 0.05). Conclusion. Use of nondrug, nonoperative interventions was low among people with hip and knee OA. Our findings show evidence-practice gaps, particularly with respect to the interventions most strongly recommended in clinical guidelines for hip and knee OA (weight loss and exercise).

Harnessing technology to deliver care by physical therapists for people with persistent joint pain: Telephone and video‐conferencing service models

“…Despite clinical guideline recommendations, participation in exercise and physical activity are generally low among people with OA (Basedow & Esterman, 2015;Hinman, Nicolson, Dobson, & Bennell, 2015;Jordan et al, 2004;Mitchell & Hurley, 2008). Although a diverse and multi-factorial range of barriers to exercise participation exist in this patient group (Dobson et al, 2016;Kanavaki et al, 2017), barriers frequently relate to the environmental context, resources, and support available to the individual, as well as to personal beliefs about both capabilities to exercise and consequences of exercise participation.…”

Patients' perceived health service needs for osteoarthritis (OA) care: a scoping systematic review

“…One barrier to implementation is engaging appropriate active patient participation in care 10 . Many patients do not engage in effective self-directed care strategies for their OA 11 . This situation is likely to be improved by better understanding patients' beliefs about health service needs for OA care in order to inform approaches aimed at maximizing participation in effective management 10,12 .…”

Physical Therapists’ Perceptions of Telephone‐ and Internet Video–Mediated Service Models for Exercise Management of People With Osteoarthritis

“…Meta‐analyses show exercise improves pain and physical function in people with OA . Clinical guidelines universally advocate exercise as an essential component of management of people with hip and knee OA , yet uptake of exercise is low . For people with OA, exercise advice is typically provided by physical therapists, and of all allied health professionals in Australia, general practitioners most frequently refer patients with OA to physical therapists .…”