Basic Body Awareness Therapy versus standard care in hip osteoarthritis. A randomized controlled trial

Abstract

Background: Compensational movement patterns in hip osteoarthritis (HOA) are associated with hip dysfunction. Basic Body Awareness Therapy (BBAT) promotes functional movement quality and might, accordingly, be beneficial in HOA.Objective: To examine the outcomes of BBAT compared to standard care in people with HOA after first receiving patient education (PE). StudyDesign: A prospective, assessor-blinded, and block-randomized controlled trial. Methods: Community-living adults with HOA participating in PE were randomly allocated to an intervention group receiving BBAT in groups (12 sessions offered once a week), or a comparison group. Data at baseline (pretest) and at 6 months (posttest) were analyzed. Primary outcomes were pain during walking assessed by the Numeric Rating Scale (NRS) and function by the Hip Osteoarthritis Outcome Score, subscale ADL (HOOS A). Secondary outcomes addressed physical capacity, movement quality, and self-reported aspects of function and health. Results: At pretest, there were no significant differences in demographic and test data between the intervention (n = 51) and the comparison (n = 50) group. Fortyone intervention and 45 comparison participants completed the posttest. At posttest, no significant differences in change between groups were found on NRS (p = 0.694, effect size (ES) = 0.02) or HOOS A (p = 0.783, ES = 0.07). Among secondary outcomes, movement quality improved significantly more (p < 0.001, ES = 0.84) in the intervention group. Compliance with BBAT varied substantially. Per-protocol analysis showed changes in favor of the intervention group for selfefficacy (p = 0.049, ES = 0.36), health (p = 0.037, ES = 0.44), and function (p = 0.029, ES = 0.53) when only intervention participants who completed at least 10 sessions of BBAT were included.Conclusions: BBAT was not found to be a more effective treatment modality than self-initiated standard care to reduce pain during walking and improve dailyThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Efficacy of basic body awareness therapy on functional outcomes: A systematic review and meta‐analysis of randomized controlled trials

“…After excluding duplicates and irrelevant papers following title and abstract screening, our search yielded 31 potential publications. Following full‐text screening, eight RCTS (Bravo, Skjaerven, Espart et al., 2019; Catalan‐Matamoros et al., 2011; Danielsson et al., 2014; Gyllensten et al., 2009; Nordbrandt et al., 2020; Olsen et al., 2022; Seferiadis et al., 2016; Yagci et al., 2018) met the inclusion criteria. Reasons for exclusion are summarized in Figure 1.…”

“…The included clinical populations comprised adults with hip osteoarthritis (Olsen et al., 2022), post‐traumatic stress disorder in refugees (Nordbrandt et al., 2020), fibromyalgia (Bravo, Skjaerven, Espart et al., 2019), chronic whiplash associated disorders (Seferiadis et al., 2016), depression (Danielsson et al., 2014), eating disorders (Catalan‐Matamoros et al., 2011), and mood disorders, somatoform disorders or personality disorders (Gyllensten et al., 2009), and adolescents with idiopathic scoliosis (Yagci et al., 2018). Functional outcomes investigated were a global assessment of functioning (Danielsson et al., 2014; Nordbrandt et al., 2020; Olsen et al., 2022), the subjective health status (Gyllensten et al., 2009; Olsen et al., 2022), overall level of psychopathology (Gyllensten et al., 2009; Nordbrandt et al., 2020), specific levels of traumatic symptoms (Nordbrandt et al., 2020), depression (Bravo, Skjaerven, Espart et al., 2019; Danielsson et al., 2014; Nordbrandt et al., 2020), anxiety (Bravo, Skjaerven, Espart et al., 2019; Danielsson et al., 2014; Nordbrandt et al., 2020), and eating disorder symptoms (Catalan‐Matamoros et al., 2011), level of disability (Nordbrandt et al., 2020), pain (Bravo, Skjaerven, Espart et al., 2019; Nordbrandt et al., 2020; Olsen et al., 2022; Seferiadis et al., 2016) including neck pain (Seferiadis et al., 2016), self‐efficacy (Olsen et al., 2022), physical fitness (Danielsson et al., 2014; Olsen et al., 2022), activity levels (Olsen et al., 2022), and QoL (Bravo, Skjaerven, Espart et al., 2019; Catalan‐Matamoros et al., 2011; Nordbrandt et al., 2020; Seferiadis et al., 2016; Yagci et al., 2018). Non‐functional (Üstün et al., 2003) BBAT outcomes, such as the Basic Awareness Rating Scale Movement Quality (Bravo, Skjaerven, Espart et al., 2019; Olsen et al., 2022), Cobb's angle (Yagci et al., 2018), Posterior Trunk Symmetry Index (Yagci et al., 2018), Walter Reed Visual ...…”

“…Functional outcomes investigated were a global assessment of functioning (Danielsson et al., 2014; Nordbrandt et al., 2020; Olsen et al., 2022), the subjective health status (Gyllensten et al., 2009; Olsen et al., 2022), overall level of psychopathology (Gyllensten et al., 2009; Nordbrandt et al., 2020), specific levels of traumatic symptoms (Nordbrandt et al., 2020), depression (Bravo, Skjaerven, Espart et al., 2019; Danielsson et al., 2014; Nordbrandt et al., 2020), anxiety (Bravo, Skjaerven, Espart et al., 2019; Danielsson et al., 2014; Nordbrandt et al., 2020), and eating disorder symptoms (Catalan‐Matamoros et al., 2011), level of disability (Nordbrandt et al., 2020), pain (Bravo, Skjaerven, Espart et al., 2019; Nordbrandt et al., 2020; Olsen et al., 2022; Seferiadis et al., 2016) including neck pain (Seferiadis et al., 2016), self‐efficacy (Olsen et al., 2022), physical fitness (Danielsson et al., 2014; Olsen et al., 2022), activity levels (Olsen et al., 2022), and QoL (Bravo, Skjaerven, Espart et al., 2019; Catalan‐Matamoros et al., 2011; Nordbrandt et al., 2020; Seferiadis et al., 2016; Yagci et al., 2018). Non‐functional (Üstün et al., 2003) BBAT outcomes, such as the Basic Awareness Rating Scale Movement Quality (Bravo, Skjaerven, Espart et al., 2019; Olsen et al., 2022), Cobb's angle (Yagci et al., 2018), Posterior Trunk Symmetry Index (Yagci et al., 2018), Walter Reed Visual Assessment Scale (Yagci et al., 2018), Scale of Body Connection (Danielsson et al., 2014), Body Attitude Test (Catalan‐Matamoros et al., 2011), Body Awareness Scale‐Health (Gyllensten et al., 2009), Arthritis Self‐Efficacy Scale (Gyllensten et al., 2009), Coping Resources Inventory (Gyllensten et al., 2009) and Sense of Coherence (Gyllensten et al., 2009) were excluded from the narrative review and meta‐analysis. The frequency and duration of the investigated BBAT interventions ranged from once weekly 60 min for 20 weeks (Nordbrandt et al., …”

“…An overview of the methodological quality of the RCTs is presented in Table 2. The PEDro score ranged from 4 (i.e., fair) (Catalan‐Matamoros et al., 2011) to 8 (i.e., good) (Olsen et al., 2022; Seferiadis et al., 2016). The most important methodological shortcoming was the blinding of the trials.…”

“…Data from four RCTs (Danielsson et al., 2014; Nordbrandt et al., 2020; Olsen et al., 2022; Yagci et al., 2018) were included in the meta‐analysis comparing BBAT with active control conditions ( n BBAT = 138, n controls = 139). Patients were diagnosed with hip osteoarthritis (Olsen et al., 2022), PTSD (Nordbrandt et al., 2020), idiopathic scoliosis (Yagci et al., 2018) and depression (Danielsson et al., 2014).…”