Article

Exercise and physical activity are a core component of knee
osteoarthritis (OA) care, yet access to physical therapists is limited for many
people. Telephone service delivery models may increase access. Objective -
Determine the effectiveness of incorporating exercise advice and behaviour change
support by physical therapists into an existing Australian nurse-led
musculoskeletal telephone service for adults with knee OA. Design : Randomized
controlled trial with nested qualitative studies.
Setting : Community,
Australia-wide.
Participants : 175 people >/=45 years with knee symptoms
consistent with a clinical diagnosis of knee OA. Eight musculoskeletal physical
therapists will provide exercise advice and support. Intervention : Random
allocation to receive existing care or exercise advice in addition to existing
care. Existing care is a minimum of one phone call from a nurse for advice on OA
self-management. Exercise advice involves 5-10 calls over 6 months from a
physical therapist trained in behaviour change support to prescribe, monitor and
progress a strengthening exercise program and physical activity plan.
Measurements : Outcomes will be measured at baseline, 6 and 12 months. Primary
outcomes are knee pain and physical function. Secondary outcomes include other
measures of knee pain, self-efficacy, physical activity and its mediators,
kinesiophobia, health service usage, work productivity, participant-perceived
change and satisfaction. Additional measures include adherence, adverse events,
therapeutic alliance, satisfaction with telephone-delivered therapy and
expectation of outcome. Semi-structured interviews with participants with knee OA
and therapists will be conducted. Limitations.: Physical therapists cannot be
blinded. Conclusions : This study will determine if incorporating exercise advice
and behaviour change support by physical therapists into a nurse-led
musculoskeletal telephone service improves outcomes for people with knee OA.
Findings will inform development and implementation of telerehabilitation services.

Langue : ANGLAIS