title: A Blended Intervention for Patients With Knee and Hip Osteoarthritis in the Physical Therapy Practice: Development and a Pilot Study.
abstract: BACKGROUND
  Blended care, a combination of online and face-to-face care, is seen as a promising treatment option. However, actual use of blended interventions in practice is disappointing.
  
  
  OBJECTIVE
  The objective of this study was two folded. The first aim was to develop a blended exercise therapy intervention for patients with knee and hip osteoarthritis that matches the values of the users and that can be implemented in the daily routine of physical therapists. The second aim was to investigate the feasibility through interviews and a pilot study.
  
  
  METHODS
  In this paper, we employed the first 3 steps of the CeHRes road map to develop a blended intervention for patients with knee and hip osteoarthritis. We used interviews, a focus group and discussions with stakeholders to explore the needs, values, and requirements with respect to our to-be-developed blended intervention, which we called e-Exercise. The first version of e-Exercise was tested in a pilot study. Feasibility outcomes, including recruitment rates within each practice, website usage (assignments completed and website visits), and user satisfaction, were measured. In addition, therapists and patients from the pilot study were interviewed to investigate users' experiences.
  
  
  RESULTS
  The study captured important information about stakeholders' needs and perspectives. Based on our findings, we created a first version and attuned the application's content, functionality, and structure. Patients and, to lesser extent, physical therapists were satisfied with the e-Exercise intervention. Eight patients were recruited by 8 physical therapists. Of the 8 patients, 6 completed more than 7 of 12 modules.
  
  
  CONCLUSIONS
  This study outlines the development and feasibility of a blended exercise therapy intervention for patients with knee and hip osteoarthritis. E-Exercise offers an alternative approach in the physical therapy treatment of knee and hip osteoarthritis. This study provides valuable information to conduct a further trial to evaluate the (cost) effectiveness of e-Exercise compared to usual physical therapy.
  
  
  BACKGROUND
  Netherlands Trial Register Number: NTR4224; www.trialregister.nl/trialreg/admin/rctview.asp?TC=4224 (Archived by WebCite at http://www.webcitation.org/6fOK4lrTO).
authors.affiliation: Netherlands Institute for Health Services Research, Utrecht, Netherlands. d.bossen@hva.nl.
authors.forename: Daniël
authors.identifier: http://orcid.org/0000-0003-3894-4245
authors.initials: D
authors.lastname: Bossen
authors.forename: Corelien
authors.identifier: http://orcid.org/0000-0003-2321-8961
authors.initials: C
authors.lastname: Kloek
authors.forename: Harm Wouter
authors.identifier: http://orcid.org/0000-0002-0490-9495
authors.initials: HW
authors.lastname: Snippe
authors.forename: Joost
authors.identifier: http://orcid.org/0000-0003-2027-0027
authors.initials: J
authors.lastname: Dekker
authors.forename: Dinny
authors.identifier: http://orcid.org/0000-0002-8661-0867
authors.initials: D
authors.lastname: de Bakker
authors.forename: Cindy
authors.identifier: http://orcid.org/0000-0003-0970-2896
authors.initials: C
authors.lastname: Veenhof
keywords: blended care; development; eHealth; osteoarthritis; physical activity; pilot study