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Associations between comorbidities and immediate and one-year outcomes following supervised exercise therapy and patient education – a cohort study of 24,513 individuals with knee or hip osteoarthritis

journal contribution
posted on 11.01.2021, 01:00 by K Pihl, Ewa Roos, RS Taylor, DT Grønne, ST Skou
© 2020 The Author(s) Objective: To investigate if comorbidities are associated with change in health outcomes following an 8-week exercise and education program in knee and hip osteoarthritis (OA). Methods: We included 24,513 individuals with knee or hip OA from the Good Life with osteoArthritis in Denmark (GLA:D®). GLA:D® consists of two patient education sessions and 12 supervised exercise sessions. Before the program, individuals self-reported having one or more of 11 common comorbidities. Physical function was assessed using the 40-m Fast-Paced Walk Test (FPWT, m/sec) before and immediately after the program. Pain intensity and health-related quality of life was self-reported before, immediately after, and at 12 months post-intervention using a visual analogue scale (VAS, 0–100) and the EQ-5D-5L index (−0.624 to 1.000), respectively. Associations of comorbidity combinations with change in outcomes immediately and at 12 months was estimated using mixed linear regression. Results: Individuals with OA improved on average 0.12 m/s (95%CI 0.12 to 0.13) in 40-m FPWT, −12.7 mm (95%CI -13.2 to −12.2) in VAS, and 0.039 (95%CI 0.036 to 0.041) in EQ-5D-5L from before to immediately after the intervention with minor additional improvements at 12 months. Despite that individuals with comorbidities had worse baseline scores in all outcomes than individuals without comorbidities, they had similar levels of improvement immediately and 12 months after the intervention. Conclusion: Comorbidities are not associated with worse nor better health outcomes following an 8-week exercise and education program in individuals with OA, suggesting exercise as a viable treatment option for individuals with OA, irrespective of comorbidities.

Funding

The initiation phase of GLA:D® was partly funded by the Danish Physiotherapy Association's fund for research, education and practice development; the Danish Rheumatism Association; and the Physiotherapy Practice Foundation.The present study was supported by the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme (MOBILIZE; grant agreement No 801790), Naestved, Slagelse and Ringsted Hospitals' Research Fund and the Danish Physiotherapy Association's fund for research, education and practice development Finally, STS is the recipient of an ongoing grant from Region Zealand (Exercise First, unrelated to the current study).

History

Publication Date

01/01/2021

Journal

Osteoarthritis and Cartilage

Volume

29

Issue

1

Pagination

11p. (p. 39-49)

Publisher

Elsevier

ISSN

1063-4584

Rights Statement

The Author reserves all moral rights over the deposited text and must be credited if any re-use occurs. Documents deposited in OPAL are the Open Access versions of outputs published elsewhere. Changes resulting from the publishing process may therefore not be reflected in this document. The final published version may be obtained via the publisher’s DOI. Please note that additional copyright and access restrictions may apply to the published version.

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