TY - JOUR
T1 - Effectiveness of behavioral graded activity in patients with osteoarthritis of the hip and/or knee
T2 - A randomized clinical trial
AU - Veenhof, Cindy
AU - Köke, Albère J.A.
AU - Dekker, Joost
AU - Oostendorp, Rob A.
AU - Bijlsma, Johannes W.J.
AU - Van Tulder, Maurits W.
AU - Van Den Ende, Cornelia H.M.
AU - Koke, A.J.A.
AU - Van den Ende, CH
PY - 2006/12/15
Y1 - 2006/12/15
N2 - Objective. To determine the effectiveness of a behavioral graded activity program (BGA) compared with usual care (UC; exercise therapy and advice) according to the Dutch guidelines for physiotherapy in patients with osteoarthritis (OA) of the hip and/or knee. The BGA intervention is intended to increase activity in the long term and consists of an exercise program with booster sessions, using operant treatment principles. Methods. We conducted a cluster randomized trial involving 200 patients with hip and/or knee OA. Primary outcome measures were pain (visual analog scale [VAS] and Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), physical function (WOMAC), and patient global assessment, assessed at weeks 0,13, 39, and 65. Secondary outcome measures comprised tiredness (VAS), patient-oriented physical function (McMaster Toronto Arthritis Patient Preference Disability Questionnaire [MACTAR]), 5-meter walking time, muscle strength, and range of motion. Data were analyzed according to intent-to-treat principle. Results. Both treatments showed short-term and long-term beneficial within-group effects. The mean differences between the 2 groups for pain and functional status were not statistically significant. Significant differences in favor of BGA were found for the MACTAR functional scale and 5-meter walking test at week 65. Conclusion. Because both interventions resulted in beneficial long-term effects, the superiority of BGA over UC has not been demonstrated. Therefore, BGA seems to be an acceptable method to treat patients with hip and/or knee OA, with equivalent results compared with UC.
AB - Objective. To determine the effectiveness of a behavioral graded activity program (BGA) compared with usual care (UC; exercise therapy and advice) according to the Dutch guidelines for physiotherapy in patients with osteoarthritis (OA) of the hip and/or knee. The BGA intervention is intended to increase activity in the long term and consists of an exercise program with booster sessions, using operant treatment principles. Methods. We conducted a cluster randomized trial involving 200 patients with hip and/or knee OA. Primary outcome measures were pain (visual analog scale [VAS] and Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), physical function (WOMAC), and patient global assessment, assessed at weeks 0,13, 39, and 65. Secondary outcome measures comprised tiredness (VAS), patient-oriented physical function (McMaster Toronto Arthritis Patient Preference Disability Questionnaire [MACTAR]), 5-meter walking time, muscle strength, and range of motion. Data were analyzed according to intent-to-treat principle. Results. Both treatments showed short-term and long-term beneficial within-group effects. The mean differences between the 2 groups for pain and functional status were not statistically significant. Significant differences in favor of BGA were found for the MACTAR functional scale and 5-meter walking test at week 65. Conclusion. Because both interventions resulted in beneficial long-term effects, the superiority of BGA over UC has not been demonstrated. Therefore, BGA seems to be an acceptable method to treat patients with hip and/or knee OA, with equivalent results compared with UC.
KW - Behavioral treatment
KW - Booster sessions
KW - Exercise therapy
KW - Graded activity
KW - Osteoarthritis
KW - Physiotherapy
KW - Randomized controlled trial
UR - http://www.scopus.com/inward/record.url?scp=33845476070&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/art.22341
DO - https://doi.org/10.1002/art.22341
M3 - Article
C2 - 17139639
SN - 2151-4658
VL - 55
SP - 925
EP - 934
JO - Arthritis care and research
JF - Arthritis care and research
IS - 6
ER -