title: Behavioural graded activity results in better exercise adherence and more physical activity than usual care in people with osteoarthritis: a cluster-randomised trial.
abstract: OBJECTIVE
  Does behavioural graded activity result in better exercise adherence and more physical activity than usual care in people with osteoarthritis of the hip or knee?
  
  
  METHODS
  Analysis of secondary outcomes of a cluster-randomised trial with concealed allocation, assessor blinding, and intention-to-treat analysis.
  
  
  METHODS
  Two hundred patients with hip and/or knee osteoarthritis.
  
  
  METHODS
  Experimental group received 18 sessions of behavioural graded activity over 12 weeks and up to 7 booster sessions over the next year. The control group received 18 sessions of usual care over 12 weeks according to the Dutch physiotherapy guideline.
  
  
  METHODS
  Exercise adherence was measured using a questionnaire and physical activity was measured using the SQUASH questionnaire at baseline, 13, and 65 weeks.
  
  
  RESULTS
  Adherence to recommended exercises was significantly higher in the experimental group than in the control group at 13 weeks (OR 4.3, 95% CI 2.1 to 9.0) and at 65 weeks (OR 3.0, 95% CI 1.5 to 6.0). Significantly more of the experimental than the control group met the recommendations for physical activity at 13 weeks (OR 5.3, 95% CI 1.9 to 14.8) and at 65 weeks (OR 2.9, 95% CI 1.2 to 6.7).
  
  
  CONCLUSIONS
  Behavioural graded activity results in better exercise adherence and more physical activity than usual care in people with osteoarthritis of the hip or knee, both in the short- and long-term.
  
  
  BACKGROUND
  NCT00522106.
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands. m.pisters@nivel.nl
authors.forename: Martijn F
authors.initials: MF
authors.lastname: Pisters
authors.forename: Cindy
authors.initials: C
authors.lastname: Veenhof
authors.forename: Dinny H
authors.initials: DH
authors.lastname: de Bakker
authors.forename: Francois G
authors.initials: FG
authors.lastname: Schellevis
authors.forename: Joost
authors.initials: J
authors.lastname: Dekker
mesh_terms: D000368:Aged; D016000:Cluster Analysis; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D015207:Osteoarthritis, Hip / Q000503:physiopathology / Q000534:rehabilitation*; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000534:rehabilitation*; D010147:Pain Measurement; D010349:Patient Compliance; D016037:Single-Blind Method; D011795:Surveys and Questionnaires; D016896:Treatment Outcome