221 Long-term maintenance of physical activity and its effect on outcomes for hip and knee osteoarthritis following the GLA:D® (Good Life with osteoArthritis Denmark) Ireland programme

TL;DR

This study examines how physical activity levels change over time in people with hip and knee osteoarthritis after participating in the GLA:D® programme in Ireland.

Contribution

The study investigates the long-term maintenance of physical activity and its impact on patient outcomes following the GLA:D® programme.

Findings

A 7.2% increase in physical activity levels was observed post-programme, but slightly decreased at 12 months.

Participants with low physical activity levels showed the greatest improvement after the programme.

Future analyses will explore the relationship between physical activity and patient outcomes like pain and quality of life.

Abstract

In recent years, focus has shifted towards utilising physical activity (PA) for improvement with the management of hip and knee osteoarthritis (OA). The GLA:D® programme, comprises of two educational and 12 supervised exercise sessions for management of hip and knee OA. Increases of 110-120% on physical activity (PA) participation post-intervention have been observed by Skou & Roos (2017); elucidating the effect these programmes have in behaviour change. The type and intensity of PA that people with OA engage with after GLA:D however, is unknown. The aim of this study is to subjectively and objectively measure the long-term changes in PA and associations with patient outcomes following the GLA:D® programme.

A preliminary analysis using data from the GLA:D Ireland Registry was performed to evaluate the change in PA (UCLA activity scale) from baseline to post-programme and 12-months follow-up. An ANOVA to assess significant differences between all 3 time-points was carried out using IBM SPSS. A sub-cohort of participants will be followed at the same time-points using accelerometery devices and a questionnaire on activity type. The relationship between change in PA and patient outcomes (pain and QOL) will be examined.

In 16 GLA:D participants with data at all time-points, an increase of 7.2% in UCLA PA levels was observed from baseline (µ=5.13 ± 1.63) to post-programme (µ=5.5 ± 1.67) and decreased by 1.1% at 12-months (µ=5.44 ± 1.86). Participants with Low UCLA levels (1-4) saw the greatest increase with 50% of participants increasing to Moderate (5-6) or High (7-10) PA post-programme. Future analyses: using subjective and objective measurements will show whether these results are replicated and how this influences patient outcomes; allowing for a thorough understanding of PA engagement.

Although marginal clinical improvements in PA are observed after GLA:D in Ireland, the promotion and sustainability of PA following a supervised programme needs to be addressed to maximise long-term behaviour change for hip and knee OA. Results will be used to design pragmatic interventions to facilitate viable pathways to community-exercise and PA for long-term OA self-management.

Health Research Board (EIA-2019-008) IMPACT - IMPlementation of osteoArthritis Clinical guidelines Together.