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Impact of an arthritis self-management programme with an added exercise component for osteoarthritic knee sufferers on improving pain, functional outcomes, and use of health care services: an experimental study [with consumer summary]
Yip YB, Sit JW, Fung KK, Wong DY, Chong SY, Chung LH, Ng TP
Patient Education and Counseling 2007 Jan;65(1):113-121
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: The aim of this study was to assess the effect of an adopted Arthritis Self-Management Programme (ASMP) with an added exercise component among osteoarthritic knee sufferers in Hong Kong. METHODS: An experimental study with 88 participants assigned to an intervention group and 94 participants to a control group. One hundred and forty-nine participants (81.9%) completed the 1 week and 120 participants (65.6%) the 16 week post-intervention assessments. Participants in the intervention group received a 6-week ASMP with an added exercise component. Outcome measures included arthritic pain and fatigue rating, practice of light exercise routines, functional status, and number of unplanned arthritis-related medical consultations. To assess the programme's effect on outcome measures, the between-groups and within-group mean changes were compared using Mann-Whitney U-test and Friedman test. RESULTS: At 16 weeks, there were significant mean changes between groups in four outcome measures: reduction in arthritis pain (p = 0.0001) and fatigue (p = 0.008), and increased duration of weekly light exercise practice (p = 0.0001) and knee flexion (p = 0.004). The ability to perform daily activities and the number of unplanned arthritis-related medical consultations show statistically significant improvements between three time-points within the intervention group only (p = 0.0001 and p = 0.005, respectively), but not between-groups (p = 0.14 and p = 0.86, respectively). Both groups apparently had no changes in muscle strength. CONCLUSION: Our findings suggest that the intervention had a positive effect in reducing pain, fatigue, knee range of motion, the practice of exercise routines, the number of medical consultations and in improving functional status and over a 16-week period. PRACTICE IMPLICATIONS: The self-management programme we applied took into account the local context and the ethnicity of the group. This process is worth further exploration and testing in different groups.
With permission from Excerpta Medica Inc.

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