Prognostic factors for health outcomes after exercise therapy and education in people with knee and hip osteoarthritis with or without comorbidities: a study of 37,576 patients treated in primary care

Pihl, K., Roos, E. M., Taylor, R. S. , Grønne, D. T. and Skou, S. T. (2022) Prognostic factors for health outcomes after exercise therapy and education in people with knee and hip osteoarthritis with or without comorbidities: a study of 37,576 patients treated in primary care. Arthritis Care and Research, 74(11), pp. 1866-1878. (doi: 10.1002/acr.24722) (PMID:34085408) (PMCID:PMC7613737)

Abstract

Objective: To identify prognostic factors for health outcomes following an eight-week supervised exercise therapy and education program for individuals with knee and hip osteoarthritis (OA) alone or with concomitant hypertension, heart or respiratory disease, diabetes, or depression. Methods: We included individuals with knee and/or hip OA from the Good Life with osteoArthritis in Denmark (GLA:D®). GLA:D® consists of two patient education sessions and 12 supervised exercise therapy sessions. Before GLA:D®, participants self-reported any comorbidities and were categorized in eight comorbidity groups. 21 potential prognostic factors (demographics, clinical data, and performance-based physical function) gathered from participants and clinicians before the program were included. Outcomes were physical function using the 40-m Fast-Paced Walk Test (FPWT), health-related quality of life using the EQ-5D-5L index score, and pain intensity using a visual analogue scale (0-100, VAS) assessed before and immediately after the GLA:D® program. Within each comorbidity group, associations of prognostic factors with outcomes were estimated using multivariable linear regression. Results: Data from 35,496 (40-m FPWT) and 37,576 (EQ-5D-5L and VAS) participants were included in the analyses. Clinically relevant associations were demonstrated between age, self-efficacy, self-rated health, and pain intensity with change in 40-m FPWT, EQ-5D-5L or VAS across comorbidity groups. Furthermore, anxiety, education, physical function, and smoking were associated with outcomes among subgroups having depression or diabetes in addition to OA. Conclusion: Age, self-efficacy, self-rated health, and pain intensity may be prognostic of change in health outcomes following an eight-week exercise therapy and patient education program for individuals with OA, irrespective of comorbidities.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Taylor, Professor Rod
• Authors: Pihl, K., Roos, E. M., Taylor, R. S., Grønne, D. T., and Skou, S. T.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
• Journal Name: Arthritis Care and Research
• Publisher: Wiley
• ISSN: 2151-464X
• ISSN (Online): 2151-4658
• Published Online: 03 June 2021
• Copyright Holders: Copyright © 2021 The Authors
• First Published: First published in Arthritis Care and Research 74(11): 1866-1878
• Publisher Policy: Reproduced under a Creative Commons License