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Nero H1,2, Cronström A1, Dahlberg L1,2
1Lund University, Orthopaedics, Lund, Sweden, 2Joint Academy, Research and Science, Malmö, Sweden
Background: Osteoarthritis (OA), a chronic disabling disease with a growing disease burden due to an increased life expectancy and a higher prevalence of inactivity, remains a challenge for the health care system. E-health has over the recent years gained momentum for treatment of chronic disease and is a promising option for delivering self-management programs with an emphasis on physiotherapy-led neuromuscular exercises, to individuals with OA. Joint Academy, an international web-based program for OA treatment, started in Sweden in 2015 and was based on the successful concept of BOA, covering education on OA, continuous physiotherapy support and daily neuromuscular exercises.
Purpose: To investigate change in patient's walking difficulty and fear of physical activity, as well as effects on joint pain, physical function and health-related quality of life in patients with OA enrolled into Joint Academy. Adding on, to observe reported pain over time in long-term JA users.
Methods: All patients with hip or knee OA, reporting ≥1 of the main outcomes and reaching ≥10% adherence, were included. Data on frequency of patients reporting walking difficulty and fear of physical activity (yes/no); pain (NRS); physical function (30s chair stand test); HRQoL (EQ5D-3L) were collected. For long-term effects on pain, weekly pain reports over 12 months were analyzed. Statistical analysis was performed using the Related Samples McNemar test and the two-tailed t-test.
Results: 654 patients (450 females, 384 knee OA, mean age 62 years, mean adherence 77%) were included. The proportion of patients with difficulty walking and experiencing fear of physical activity decreased by 23% and 66%, respectively (p 0.001). Baseline pain, physical function and EQ5D index were 5.6 (SD 2.1), 11 (SD 4) and 0.65 (SD 0.15), respectively. After six weeks, pain had decreased to 4.2 (SD 2.2), while physical function and HRQoL had improved to 13 (SD 5) and 0.68 (SD 0.15) (p 0.001). At treatment week 48, mean pain of long-term users was 2.3 (SD 1.9).
Conclusion(s): The web-based self-management program shows potential to benefit several aspects of the complex disease that is OA by decreasing pain, increasing physical function and lessening walking difficulties whilst alleviating patients from fears of one of the cornerstone treatments of OA, namely physical activity. Preliminary results on long-term effects on pain are promising and further results will be presented at WCPT 2019.
Implications: This innovative management platform gives clinically meaningful results, is easily scalable, population specific and can have a tremendous beneficial effect on health care by improving a variety of symptoms of OA.
Keywords: Osteoarthritis, e-health, self-management
Funding acknowledgements: Lund University, Joint Academy
Purpose: To investigate change in patient's walking difficulty and fear of physical activity, as well as effects on joint pain, physical function and health-related quality of life in patients with OA enrolled into Joint Academy. Adding on, to observe reported pain over time in long-term JA users.
Methods: All patients with hip or knee OA, reporting ≥1 of the main outcomes and reaching ≥10% adherence, were included. Data on frequency of patients reporting walking difficulty and fear of physical activity (yes/no); pain (NRS); physical function (30s chair stand test); HRQoL (EQ5D-3L) were collected. For long-term effects on pain, weekly pain reports over 12 months were analyzed. Statistical analysis was performed using the Related Samples McNemar test and the two-tailed t-test.
Results: 654 patients (450 females, 384 knee OA, mean age 62 years, mean adherence 77%) were included. The proportion of patients with difficulty walking and experiencing fear of physical activity decreased by 23% and 66%, respectively (p 0.001). Baseline pain, physical function and EQ5D index were 5.6 (SD 2.1), 11 (SD 4) and 0.65 (SD 0.15), respectively. After six weeks, pain had decreased to 4.2 (SD 2.2), while physical function and HRQoL had improved to 13 (SD 5) and 0.68 (SD 0.15) (p 0.001). At treatment week 48, mean pain of long-term users was 2.3 (SD 1.9).
Conclusion(s): The web-based self-management program shows potential to benefit several aspects of the complex disease that is OA by decreasing pain, increasing physical function and lessening walking difficulties whilst alleviating patients from fears of one of the cornerstone treatments of OA, namely physical activity. Preliminary results on long-term effects on pain are promising and further results will be presented at WCPT 2019.
Implications: This innovative management platform gives clinically meaningful results, is easily scalable, population specific and can have a tremendous beneficial effect on health care by improving a variety of symptoms of OA.
Keywords: Osteoarthritis, e-health, self-management
Funding acknowledgements: Lund University, Joint Academy
Topic: Orthopaedics; Musculoskeletal
Ethics approval required: Yes
Institution: Lund University
Ethics committee: Regional Ethics Board in Lund, Sweden
Ethics number: Dnr 2017/651 and 2018/560
All authors, affiliations and abstracts have been published as submitted.
