scholarly journals Associations between comorbidities and immediate and one-year outcomes following supervised exercise therapy and patient education – A cohort study of 24,513 individuals with knee or hip osteoarthritis

2021 ◽  
Vol 29 (1) ◽  
pp. 39-49
Author(s):  
K. Pihl ◽  
E.M. Roos ◽  
R.S. Taylor ◽  
D.T. Grønne ◽  
S.T. Skou
Keyword(s):  
Cohort Study ◽  
Patient Education ◽  
Exercise Therapy ◽  
Hip Osteoarthritis ◽  
Supervised Exercise ◽  
One Year

scholarly journals Patients use fewer analgesics following supervised exercise therapy and patient education: an observational study of 16 499 patients with knee or hip osteoarthritis

2020 ◽  
pp. bjsports-2019-101265
Author(s):  
Jonas Bloch Thorlund ◽  
Ewa M Roos ◽  
Patricia Goro ◽  
Emily Gromelsky Ljungcrantz ◽  
Dorte Thalund Grønne ◽  
...  
Keyword(s):  
Patient Education ◽  
Exercise Therapy ◽  
Lower Risk ◽  
Hip Osteoarthritis ◽  
Education Programme ◽  
Relative Reduction ◽  
Supervised Exercise ◽  
Analgesic Use ◽  
Patient Education Programme

ObjectivesTo investigate changes in analgesic use before and after supervised exercise therapy and patient education in patients with knee or hip osteoarthritis (OA).MethodsWe recruited 16 499 of 25 933 eligible patients (64%; mean age 64.9; SD 9.6; 73% women) from the Good Life with osteoArthritis in Denmark (GLA:D) registry. Change in proportions of analgesic users (categorised according to analgesic risk profile; opioids > non-steroidal anti-inflammatory drugs > paracetamol) was assessed from before to after an 8-week supervised exercise therapy and patient education programme targeting knee or hip OA pain and functional limitations.ResultsPatients reported 13.2 mm (95% CI 12.8 to 13.6) less pain (visual analogue scale 0–100 mm) at follow-up compared with baseline. The proportion of analgesic users reduced from 62.2% (95% CI 61.5 to 63.0) at baseline to 44.1% (95% CI 43.3 to 44.9) at follow-up (absolute change: 18.1% (95% CI 17.3 to 19.0)). Among patients using analgesics at baseline, 52% changed to a lower risk analgesic or discontinued analgesic use. The proportion of opioid users after the exercise therapy was 2.5% (95% CI 2.1 to 2.9) lower than baseline; this represents a relative reduction of 36%.ConclusionAmong patients with knee or hip OA using analgesics, more than half either discontinued analgesic use or shifted to lower risk analgesics following an 8-week structured exercise therapy and patient education programme (GLA:D). These data encourage randomised controlled trial evaluation of whether supervised exercise therapy, combined with patient education, can reduce analgesic use, including opioids, among patients with knee and hip OA pain.

scholarly journals Protocol for a prospective, longitudinal cohort study on the effect of arterial disease level on the outcomes of supervised exercise in intermittent claudication: the ELECT Registry

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e025419 ◽  
Author(s):  
Marijn ML van den Houten ◽  
Sandra CP Jansen ◽  
Anneroos Sinnige ◽  
Lijckle van der Laan ◽  
Patrick WHE Vriens ◽  
...  
Keyword(s):  
Cohort Study ◽  
Peripheral Arterial Disease ◽  
Intermittent Claudication ◽  
Exercise Therapy ◽  
Imaging Modality ◽  
Arterial Disease ◽  
Invasive Treatment ◽  
Supervised Exercise ◽  
Peripheral Arterial ◽  
Prospective Longitudinal

IntroductionDespite guideline recommendations advocating conservative management before invasive treatment in intermittent claudication, early revascularisation remains widespread in patients with favourable anatomy. The aim of the Effect of Disease Level on Outcomes of Supervised Exercise in Intermittent Claudication Registry is to determine the effect of the location of stenosis on the outcomes of supervised exercise in patients with intermittent claudication due to peripheral arterial disease.Methods and analysisThis multicentre prospective cohort study aims to enrol 320 patients in 10 vascular centres across the Netherlands. All patients diagnosed with intermittent claudication (peripheral arterial disease: Fontaine II/Rutherford 1–3), who are considered candidates for supervised exercise therapy by their own physicians are appropriate to participate. Participants will receive standard care, meaning supervised exercise therapy first, with endovascular or open revascularisation in case of insufficient effect (at the discretion of patient and vascular surgeon). For the primary objectives, patients are grouped according to anatomical characteristics of disease (aortoiliac, femoropopliteal or multilevel disease) as apparent on the preferred imaging modality in the participating centre (either duplex, CT angiography or magnetic resonance angiography). Changes in walking performance (treadmill tests, 6 min walk test) and quality of life (QoL; Vascular QoL Questionnaire-6, WHO QoL Questionnaire-Bref) will be compared between groups, after multivariate adjustment for possible confounders. Freedom from revascularisation and major adverse cardiovascular disease events, and attainment of the treatment goal between anatomical groups will be compared using Kaplan-Meier survival curves.Ethics and disseminationThis study has been exempted from formal medical ethical approval by the Medical Research Ethics Committees United ‘MEC-U’ (W17.071). Results are intended for publication in peer-reviewed journals and for presentation to stakeholders nationally and internationally.Trial registration numberNTR7332; Pre-results.

scholarly journals The Effect of Arterial Disease Level on Outcomes of Supervised Exercise Therapy in Intermittent Claudication: A Prospective Cohort Study

2020 ◽  
Vol 72 (1) ◽  
pp. e31
Author(s):  
Marijn van den Houten ◽  
Anneroos Sinnige ◽  
Lijckle van der Laan ◽  
Patrick Vriens ◽  
Edith Willigendael ◽  
...  
Keyword(s):  
Cohort Study ◽  
Intermittent Claudication ◽  
Prospective Cohort Study ◽  
Exercise Therapy ◽  
Prospective Cohort ◽  
Arterial Disease ◽  
Supervised Exercise
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