Better Knee, Better Me™: effectiveness of two scalable health care interventions supporting self-management for knee osteoarthritis – protocol for a randomized controlled trial

Abstract

Background: Although education, exercise, and weight loss are recommended for management of knee osteoarthritis, the additional benefits of incorporating weight loss strategies into exercise interventions have not been well investigated. The aim of this study is to compare, in a private health insurance setting, the clinical-and cost-effectiveness of a remotely-delivered, evidence-and theory-informed, behaviour change intervention targeting exercise and self-management (Exercise intervention), with the same intervention plus active weight management (Exercise plus weight management intervention), and with an information-only control group for people with knee osteoarthritis who are overweight or obese.

Effects of adding a diet intervention to exercise on hip osteoarthritis pain: protocol for the ECHO randomized controlled trial

“…The interventions are based on a diet and exercise program developed by the researchers for people with knee OA [ 28 ], with input from various stakeholders, and are reported according to TIDIeR recommendations [ 29 ]. Clinical consultations are informed by the Behaviour Change Wheel [ 30 ] and based on research into exercise [ 28 , 31 ] and weight management [ 22 ] for hip and knee OA.…”

“…The interventions are based on a diet and exercise program developed by the researchers for people with knee OA [ 28 ], with input from various stakeholders, and are reported according to TIDIeR recommendations [ 29 ]. Clinical consultations are informed by the Behaviour Change Wheel [ 30 ] and based on research into exercise [ 28 , 31 ] and weight management [ 22 ] for hip and knee OA. Prior to the first consultation with the physiotherapist and dietitian, participants will complete a pre-consultation survey asking about their main problems and goals, brief history of their hip symptoms and other health issues and previous weight management if they are allocated to the weight loss and exercise group.…”

“…All dietitians will complete i) training in best-practice OA management delivered by researchers; ii) motivational interviewing skills delivered by Health and Wellbeing Training Consultants over 2-days; iii) ketogenic VLCD delivered by researchers via 1-h webinar. Further details on training have been published elsewhere [ 28 ]. Telephone meetings will be conducted between the research team, physiotherapists and dietitians to address any study issues that arise.…”

Adherence to and the Maintenance of Self-Management Behaviour in Older People with Musculoskeletal Pain—A Scoping Review and Theoretical Models

“… Reference Reasons for Excluding the Study Ang et al 2011 and 2013 [ 46 , 47 ] The mean age of the study population was 46 years Aragonés et al [ 48 ] The mean age of the study population was 48 years Beissner et al [ 49 ] Adherence of physiotherapists to the treatment regime was studied. Bennell et al [ 50 ] The mean age of the study population was approximately 62 years Bennell et al [ 51 ] The study protocol was inappropriate Bennell et al [ 52 ] The mean age of the study population was 62 years Bourgault et al [ 53 ] The mean age of the study population was approximately 48 years Bove et al [ 54 ] The study was a qualitative study based on an RCT that has not been published yet Brady et al 2017 and 2018 [ 55 , 56 ] The study from 2017 was a study protocol The mean age of the study population was 55 years Cooke et al [ 57 ] A pain-related self-management intervention was not included Dziedzic et al 2014 and 2018 [ 58 , 59 ] The study protocol was inappropriate * Did not fulfil the self-management programme definition: two scores of yes (2 and 4), two scores of partly (1 and 3), and two scores of no (5 and 6) …”

Muscle Forces during Weight-Bearing Exercises in Medial Knee Osteoarthritis and Varus Malalignment: A Cross-Sectional Study

“…Although the best type of strengthening exercise for clinical benefits in knee OA is unclear (3,9), weight-bearing exercises are often used to provide resistance and/or facilitate neuromotor control (9)(10)(11)(12). Weight-bearing exercise integrates multiple muscle groups and agonist/antagonist pairs and is more reflective of functional movements (e.g., standing up from seated position) than non-weight-bearing exercises, which tend to isolate a single muscle group (9,10).…”