Telephone Coaching to Enhance a Home-Based Physical Activity Program for Knee Osteoarthritis: A Randomized Clinical Trial.
To investigate whether simultaneous telephone coaching improves the clinical effectiveness of a physiotherapist-prescribed home-based physical activity program for knee osteoarthritis (OA).



A total of 168 inactive adults ages ≥50 years with knee pain on a numeric rating scale ≥4 (NRS; range 0-10) and knee OA were recruited from the community and randomly assigned to a physiotherapy (PT) and coaching group (n = 84) or PT-only (n = 84) group. All participants received five 30-minute consultations with a physiotherapist over 6 months for education, home exercise, and physical activity advice. PT+coaching participants also received 6-12 telephone coaching sessions by clinicians trained in behavioral-change support for exercise and physical activity. Primary outcomes were pain (NRS) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC; score range 0-68]) at 6 months. Secondary outcomes were these same measures at 12 and 18 months, as well as physical activity, exercise adherence, other pain and function measures, and quality of life. Analyses were intent-to-treat with multiple imputation for missing data.



A total of 142 (85%), 136 (81%), and 128 (76%) participants completed 6-, 12-, and 18-month measurements, respectively. The change in NRS pain (mean difference 0.4 unit [95% confidence interval (95% CI) -0.4, 1.3]) and in WOMAC function (1.8 [95% CI -1.9, 5.5]) did not differ between groups at 6 months, with both groups showing clinically relevant improvements. Some secondary outcomes related to physical activity and exercise behavior favored PT+coaching at 6 months but generally not at 12 or 18 months. There were no between-group differences in most other outcomes.



The addition of simultaneous telephone coaching did not augment the pain and function benefits of a physiotherapist-prescribed home-based physical activity program.
University of Melbourne, Melbourne, Victoria, Australia.
Kim L
KL
Bennell
University of Melbourne, Melbourne, Victoria, Australia.
Penny K
PK
Campbell
University of Melbourne, Melbourne, Victoria, Australia.
Thorlene
T
Egerton
University of Melbourne, Melbourne, Victoria, Australia.
Ben
B
Metcalf
Monash University, Melbourne, Victoria, Australia.
Jessica
J
Kasza
Monash University, Melbourne, Victoria, Australia.
Andrew
A
Forbes
HealthChange Australia, Sydney, New South Wales, Australia.
Caroline
C
Bills
HealthChange Australia, Sydney, New South Wales, Australia.
Janette
J
Gale
Monash University, Melbourne, Victoria, Australia.
Anthony
A
Harris
Western Sydney University, Sydney, New South Wales, Australia.
Gregory S
GS
Kolt
Medibank, Docklands, Victoria, Australia, and Monash University, Melbourne, Victoria, Australia.
Stephen J
SJ
Bunker
Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia.
David J
DJ
Hunter
Melbourne EpiCentre, University of Melbourne, Melbourne Health, and Monash University, Melbourne, Victoria, Australia.
Caroline A
CA
Brand
University of Melbourne, Melbourne, Victoria, Australia.
Rana S
RS
Hinman
D000368:Aged; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D013689:Telephone; D000069350:Telerehabilitation / Q000379:methods*