Telephone Coaching to Enhance a Home-Based Physical Activity Program for Knee Osteoarthritis

A Randomized Clinical Trial

Kim L Bennell, Penny K. Campbell, Thorlene Egerton, Ben Metcalf, Jessica Kasza, Andrew Forbes, Caroline Bills, Janette Gale, Anthony Harris, Gregory S. Kolt, Steven J Bunker, David J. Hunter, Caroline A Brand, Rana S Hinman

Research output: Contribution to journalArticleResearchpeer-review

19 Citations (Scopus)

Abstract

Objective: To investigate whether simultaneous telephone coaching improves the clinical effectiveness of a physiotherapist-prescribed home-based physical activity program for knee osteoarthritis (OA). Methods: 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. Results: 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. Conclusion: The addition of simultaneous telephone coaching did not augment the pain and function benefits of a physiotherapist-prescribed home-based physical activity program.

Original languageEnglish
Pages (from-to)84-94
Number of pages11
JournalArthritis Care and Research
Volume69
Issue number1
DOIs
Publication statusPublished - 1 Jan 2017

Cite this

Bennell, Kim L ; Campbell, Penny K. ; Egerton, Thorlene ; Metcalf, Ben ; Kasza, Jessica ; Forbes, Andrew ; Bills, Caroline ; Gale, Janette ; Harris, Anthony ; Kolt, Gregory S. ; Bunker, Steven J ; Hunter, David J. ; Brand, Caroline A ; Hinman, Rana S. / Telephone Coaching to Enhance a Home-Based Physical Activity Program for Knee Osteoarthritis : A Randomized Clinical Trial. In: Arthritis Care and Research. 2017 ; Vol. 69, No. 1. pp. 84-94.
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abstract = "Objective: To investigate whether simultaneous telephone coaching improves the clinical effectiveness of a physiotherapist-prescribed home-based physical activity program for knee osteoarthritis (OA). Methods: 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. Results: 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. Conclusion: The addition of simultaneous telephone coaching did not augment the pain and function benefits of a physiotherapist-prescribed home-based physical activity program.",
author = "Bennell, {Kim L} and Campbell, {Penny K.} and Thorlene Egerton and Ben Metcalf and Jessica Kasza and Andrew Forbes and Caroline Bills and Janette Gale and Anthony Harris and Kolt, {Gregory S.} and Bunker, {Steven J} and Hunter, {David J.} and Brand, {Caroline A} and Hinman, {Rana S}",
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Telephone Coaching to Enhance a Home-Based Physical Activity Program for Knee Osteoarthritis : A Randomized Clinical Trial. / Bennell, Kim L; Campbell, Penny K.; Egerton, Thorlene; Metcalf, Ben; Kasza, Jessica; Forbes, Andrew; Bills, Caroline; Gale, Janette; Harris, Anthony; Kolt, Gregory S.; Bunker, Steven J; Hunter, David J.; Brand, Caroline A; Hinman, Rana S.

In: Arthritis Care and Research, Vol. 69, No. 1, 01.01.2017, p. 84-94.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Telephone Coaching to Enhance a Home-Based Physical Activity Program for Knee Osteoarthritis

T2 - A Randomized Clinical Trial

AU - Bennell, Kim L

AU - Campbell, Penny K.

AU - Egerton, Thorlene

AU - Metcalf, Ben

AU - Kasza, Jessica

AU - Forbes, Andrew

AU - Bills, Caroline

AU - Gale, Janette

AU - Harris, Anthony

AU - Kolt, Gregory S.

AU - Bunker, Steven J

AU - Hunter, David J.

AU - Brand, Caroline A

AU - Hinman, Rana S

PY - 2017/1/1

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N2 - Objective: To investigate whether simultaneous telephone coaching improves the clinical effectiveness of a physiotherapist-prescribed home-based physical activity program for knee osteoarthritis (OA). Methods: 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. Results: 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. Conclusion: The addition of simultaneous telephone coaching did not augment the pain and function benefits of a physiotherapist-prescribed home-based physical activity program.

AB - Objective: To investigate whether simultaneous telephone coaching improves the clinical effectiveness of a physiotherapist-prescribed home-based physical activity program for knee osteoarthritis (OA). Methods: 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. Results: 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. Conclusion: The addition of simultaneous telephone coaching did not augment the pain and function benefits of a physiotherapist-prescribed home-based physical activity program.

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