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22.03.2017 | Original Article | Ausgabe 7/2017

Clinical Rheumatology 7/2017

An evidence-based walking program among older people with knee osteoarthritis: the PEP (participant exercise preference) pilot randomized controlled trial

Zeitschrift:
Clinical Rheumatology > Ausgabe 7/2017
Autoren:
Laurianne Loew, Lucie Brosseau, Glen P. Kenny, Natalie Durand-Bush, Stéphane Poitras, Gino De Angelis, George A. Wells
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s10067-017-3606-9) contains supplementary material, which is available to authorized users.
Lucie Brosseau and George A. Wells contributed equally to this work.
Trial Registration
International Standard Randomized Controlled Trial Number Register (ISRCTN no. 51981241) and Current Controlled Trials.

Abstract

Knee osteoarthritis is a common joint problem leading to an increase of pain and a loss of function in older individuals. The main objective of this study was to evaluate if a participant who was randomly assigned to his preferred group improved his adherence to an effective walking program compared to a participant who did not receive his preferred group. This was a 9-month pilot randomized clinical trial, based on a patient treatment preferences design. The 69 eligible participants had a diagnosis of knee osteoarthritis. Participants were randomized to one of two groups: a supervised community-based or unsupervised walking program, based on the Ottawa Panel guidelines. At 6 months, participants who expressed a preference, either for the supervised or unsupervised program, and who were assigned to their preferred choice of program showed significantly higher adherence to walking sessions (supervised 60.7 ± 12.3%, P < 0.0001; unsupervised 43.1 ± 12.1%, P = 0.03), compared to the participants who did not obtain their preferred choice of program. After 9 months, significant improvements were shown according to the level of stiffness evaluated with the WOMAC (P = 0.01) and the functional status assessed with the Timed Up and GO Test (P = 0.04), among the adherent participants who obtained their preference, as compared to those who did not receive their preference. We show this approach promotes long-term adherence to a community-based walking program, while ensuring the maintenance of clinical benefits of walking, among older adults susceptible to avoid or not properly engage in physical activity.

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