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. 2023 Apr 26:4:1147938.
doi: 10.3389/fresc.2023.1147938. eCollection 2023.

A scalable 12-week exercise and education programme reduces symptoms and improves function and wellbeing in people with hip and knee osteoarthritis

Jemma L Smith  1 , Aidan Q Innes  1 , Danielle S Burns  1   2 , Davina Deniszczyc  1 , James Selfe  2 , Stephen MacConville  1 , Kevin Deighton  1 , Benjamin M Kelly  1   2
Affiliations

A scalable 12-week exercise and education programme reduces symptoms and improves function and wellbeing in people with hip and knee osteoarthritis

Jemma L Smith et al. Front Rehabil Sci. .

Abstract

Introduction: Osteoarthritis is a chronic musculoskeletal condition that impacts more than 300 million people worldwide, with 43 million people experiencing moderate to severe disability due to the disease. This service evaluation provides the results from a tailored blended model of care on joint health, physical function, and personal wellbeing.

Methods: 1,593 adult participants with osteoarthritis completed the Nuffield Health Joint Pain Programme between February 2019 and May 2022. The 12-week programme included two 40-min exercise sessions per week. All exercise sessions were conducted face-to-face and were followed by 20 min of education to provide information and advice on managing osteoarthritis.

Results: The 12-week joint pain programme significantly improved Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) global scores (Week 0: 37.5 [17.2]; Week 12: 24.0 [16.6]; p < 0.001), as well as subscales for pain (Week 0: 7.6 [3.7]; Week 12: 4.9 [3.7]; p < 0.001), function (Week 0: 26.0 [13.0]; Week 12: 16.3 [12.4]; p < 0.001), and stiffness (Week 0: 3.9 [1.6]; Week 12: 2.8 [1.7]; p < 0.001). Significant improvements in health-related outcomes including systolic and diastolic blood pressure (Week 0: 139 [18] mmHg; Week 12: 134 [17] mmHg, and Week 0: 82 [11] mmHg; Week 12: 79 [19] mmHg; both p < 0.001), body mass index (Week 0: 29.0 [4.5] kg/m2; Week 12: 28.6 [4.4] kg/m2; p < 0.001), waist to hip ratio (Week 0: 0.92 [0.23]; Week 12: 0.90 [0.11], p < 0.01) and timed up and go (Week 0: 10.8 s [2.9]; Week 12: 8.1 s [2.0]; p < 0.001) were also observed. On completion of the joint pain programme, participants also reported significant improvements in all assessed aspects of self-reported wellbeing (all p < 0.001).

Discussion: With reductions in physical symptoms of osteoarthritis and improvements in personal wellbeing, the joint pain programme delivered by personal trainers in a gym-setting offers a nationally scalable, non-pharmacological treatment pathway for osteoarthritis.

Keywords: exercise; hip; joint; knee; osteoarthritis; wellbeing.

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Conflict of interest statement

JLS, AQI, DD, SM, KD and BMK are employees of Nuffield Health. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Baseline and Week 12 values for global WOMAC scores (A); pain score (B); stiffness score (C); and function score (D). Values are presented as mean (95% CI). Higher scores indicate worse symptoms for WOMAC scores. Differences between time points were analysed using paired t-tests. For all groups, all p < 0.001. All patients Combined: n = 1593; Hip only: n = 505; Knee only: n = 1,055; Hip & Knee: n = 33.
Figure 2
Figure 2
Baseline and Week 12 values for ONS-4 self-reported life satisfaction (A), life being worthwhile (B), happiness (C) and anxiety scores (D). Values are presented as mean (95% CI). Lower scores indicate worse health for ONS4 life satisfaction, life is worthwhile and happiness scores. Higher scores indicate worse health for ONS4 anxiety. Differences between time points were analysed using paired t-tests. For all groups, all p < 0.001. Combined: n = 1278; Hip scores: n = 413; Knee scores: n = 850; Hip & Knee: n = 15.
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