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Meta-Analysis
. 2015 Aug 10;5(8):e007642.
doi: 10.1136/bmjopen-2015-007642.

Behavioural physical activity interventions in participants with lower-limb osteoarthritis: a systematic review with meta-analysis

Wilby Williamson  1 , Stefan Kluzek  2 , Nia Roberts  3 , Justin Richards  4 , Nigel Arden  2 , Paul Leeson  1 , Julia Newton  2 , Charlie Foster  5
Affiliations
Meta-Analysis

Behavioural physical activity interventions in participants with lower-limb osteoarthritis: a systematic review with meta-analysis

Wilby Williamson et al. BMJ Open. .

Abstract

Objective: To assess effectiveness of osteoarthritis interventions to promote long-term physical activity behaviour change.

Design: A systematic review and meta-analysis. Protocol registration PROSPERO CRD4201300444 5 (http://www.crd.york.ac.uk/prospero/).

Study selection: Randomised controlled trials (RCTs) comparing physical activity interventions with placebo, no/or minimal intervention in community-dwelling adults with symptomatic knee or hip osteoarthritis. Primary outcomes were change in physical activity or cardiopulmonary fitness after a minimum follow-up of 6 months.

Data extraction: Outcomes were measures of physical activity (self-reported and objectively measured) and cardiovascular fitness. Standard mean differences between postintervention values were used to describe the effect sizes.

Results: 27,984 titles were screened and 180 papers reviewed in full. Eleven RCTs satisfied inclusion criteria, total study population of 2741 participants, mean age 62.2. The commonest reasons for study exclusion were follow-up less than 6 months and no physical activity measures. The majority of included interventions implement an arthritis self-management programme targeting coping skills and self-efficacy. Seven studies used self-report measures, the pooled effect of these studies was small with significant heterogeneity between studies (SMD 0.22 with 95% CI -0.11 to 0.56, z=1.30 (p=0.19) I(2) statistic of 85%). Subgroup analysis of 6-12 month outcome reduced heterogeneity and increased intervention effect compared to control (SMD 0.53, 95% CI 0.41 to 0.65, z=8.84 (p<0.00001) I(2) of 66%).

Conclusions: Arthritis self-management programmes achieve a small but significant improvement in physical activity in the short term. Effectiveness of intervention declines with extended follow-up beyond 12 months with no significant benefit compared to control. The small number of studies (11 RCTs) limited ability to define effective delivery methods. Investigation of behavioural lifestyle interventions for lower limb osteoarthritis populations would benefit from consensus on methodology and outcome reporting. This includes use of validated physical activity reporting tools and planning for long-term follow-up.

Keywords: REHABILITATION MEDICINE; RHEUMATOLOGY; SPORTS MEDICINE.

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Figures

Figure 1
Figure 1
PRISMA flow diagram; randomised controlled trail study selection.
Figure 2
Figure 2
Forest plot for meta-analysis of self-reported physical activity outcomes following exercise intervention.
See this image and copyright information in PMC

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References

    1. Murphy L, Schwartz TA, Helmick CG et al. . Lifetime risk of symptomatic knee osteoarthritis. Arthritis Rheum 2008;59:1207–13. 10.1002/art.24021 - DOI - PMC - PubMed
    1. Lawrence RC, Felson DT, Helmick CG et al. , National Arthritis Data Workgroup. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum 2008;58:26–35. 10.1002/art.23176 - DOI - PMC - PubMed
    1. Hiligsmann M, Cooper C, Arden N et al. . Health economics in the field of osteoarthritis: an expert's consensus paper from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Semin Arthritis Rheum 2013;43:303–13. 10.1016/j.semarthrit.2013.07.003 - DOI - PubMed
    1. Hawker G, Croxford R, Bierman A. All-cause mortality and serious cardiovascular events in people with hip and knee osteoarthritis: a population based cohort study. PLoS ONE 2014;9:e91286 10.1371/journal.pone.0091286 - DOI - PMC - PubMed
    1. Nüesch E, Dieppe P, Reichenbach S et al. . All cause and disease specific mortality in patients with knee or hip osteoarthritis: population based cohort study. BMJ 2011;342:d1165 10.1136/bmj.d1165 - DOI - PMC - PubMed

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