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. 2020 Sep 26;9(10):3112.
doi: 10.3390/jcm9103112.

The Active with OsteoArthritis (AktivA) Physiotherapy Implementation Model: A Patient Education, Supervised Exercise and Self-Management Program for Patients with Mild to Moderate Osteoarthritis of the Knee or Hip Joint. A National Register Study with a Two-Year Follow-Up

Inger Holm  1   2 , Are Hugo Pripp  3 , May Arna Risberg  2   4
Affiliations

The Active with OsteoArthritis (AktivA) Physiotherapy Implementation Model: A Patient Education, Supervised Exercise and Self-Management Program for Patients with Mild to Moderate Osteoarthritis of the Knee or Hip Joint. A National Register Study with a Two-Year Follow-Up

Inger Holm et al. J Clin Med. .

Abstract

Background: Recent systematic reviews and international guidelines recommend patient education, exercises, and weight control (if overweight) as first-line treatment for patients with hip or knee osteoarthritis (OA). The Active with osteoArthritis (AktivA) program is a physiotherapy model for the implementation of these guidelines into clinical primary care practice. The purpose of the present study was to evaluate the long-term effects of and adherence to the AktivA program for patients with mild to moderate knee or hip OA.

Methods: The AktivA program includes three modules: a physiotherapy certification course, a patient education and exercise program and an electronic quality register. An electronic questionnaire including questions about, pain, quality of life, physical activity, self-efficacy and satisfaction with the AktivA program are sent to the participants at inclusion and after 3, 12 and 24 months. A linear mixed model for repeated measurements was used to assess the difference between the follow-up times.

Results: Until January 2020, 6245 patients were included in the register. The response rates were 98%, 86% and 63% at 3, 12 and 24 months, respectively. After participating in the AktivA program, the patients reported decreased pain and increased health-related and disease-specific quality of life at three months and the positive effect was maintained up to two years after inclusion. The proportion of patients reporting to be inactive or having a low physical activity level was reduced from 43% to 22%. After two years, more than 80% of the participants reported to use what they have learned from the AktivA program at least once a week.

Conclusions: Two years after inclusion in the AktivA physiotherapy program, the patients still report reduced pain, increased quality of life and higher activity levels.

Keywords: exercise therapy; implementation of guidelines; osteoarthritis; patient education; patient-reported outcomes; physical activity; physiotherapy.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Pain during the last month (numeric rating scale 0–10) at baseline, 3, 12 and 24 months.
Figure 2
Figure 2
Joint related quality of life (QoL) (HOOS */KOOS **, scale 0 = worst–100 = best) at baseline, 3, 12 and 24 months given by estimated marginal means with 95% confidence intervals. * Knee injury and Osteoarthritis Outcome Score ** Hip disability and Osteoarthritis Outcome Score.
Figure 3
Figure 3
Difficulties in sport-related activities (SP) (HOOS */KOOS **, scale 0 = worst–100 = best) at baseline, 3, 12 and 24 months given by estimated marginal means with 95% confidence intervals. * Knee injury and Osteoarthritis Outcome Score ** Hip disability and Osteoarthritis Outcome Score.
Figure 4
Figure 4
Distribution (given in %) of patient-reported physical activity levels at baseline, 3, 12 and 24 months in patients with knee or hip osteoarthritis who have participated in the Active with osteoArthritis (AktivA) education and supervised exercise program.
See this image and copyright information in PMC

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