Effectiveness of behavioural change techniques in physiotherapy interventions to promote physical activity adherence in patients with hip and knee osteoarthritis: a systematic review protocol

Abstract

IntroductionOsteoarthritis (OA) is a common degenerative articular disease, the highest cause of individual level disability and a significant socioeconomic burden to healthcare services. Patient education and physical activity (PA) prescription are recommended components of interventions in several healthcare guidelines and are commonly provided by physiotherapists. However, these interventions lack long-term clinical effectiveness. Patient adherence to PA prescription requires patients to modify their PA behaviour and appears critical in maintaining symptomatic improvements. This systematic review aims to evaluate the effectiveness of behavioural change techniques (BCTs) used in physiotherapy interventions to improve PA adherence.Methods and analysisMedline, Cochrane and PEDro registers of Controlled Trials, EMBASE, CINAHL and PsycInfo databases, and key grey literature sources will be rigorously searched for randomised controlled trials that compared a physiotherapy intervention incorporating BCTs with other therapies, placebo interventions, usual care or no-treatment. Two independent researchers will conduct literature searches, assess trial eligibility, extract data, conduct risk of bias assessment (using Cochrane risk of bias tool), classify BCTs and evaluate the quality of the body of literature following Grading of Recommendations, Assessment, Development and Evaluation (GRADE) guidelines. Narrative synthesis of key outcomes will be presented and meta-analysis will be performed if included trials are clinically homogenous, based on their intervention and comparator groups and outcome measures. This review will be reported in line with the Preferred Reporting Items for Systematic review and Meta-Analysis guidelines.Ethics and disseminationResearch ethics approval is not required. This review will help inform clinicians and researchers on the most effective behavioural change techniques used in physiotherapy interventions to enhance adherence to PA prescription for patients with lower limb OA. The findings will be disseminated through publication in a peer-reviewed journal and conference presentations.Trial registration numberPROSPERO CRD42016039932.

Factors associated with stroke survivors’ inconsistent uptake of physiotherapy interventions at Turton Community Health Centre, KwaZulu-Natal

“…Stroke survivors are health outcome-driven and may not exercise patience until results are yielded. Perhaps, this talks to the missed opportunities by healthcare practitioners in utilising various resources, such as behaviour change models, to enhance stroke survivors’ uptake of physiotherapy interventions (Basset 2015 ; Keogh et al 2015 ; Willet et al 2017 ).…”

Effectiveness of behaviour change techniques in physiotherapy interventions to promote physical activity adherence in lower limb osteoarthritis patients: A systematic review

“…A systematic review was conducted according to a registered (CRD42016039932) and published protocol [35] using methodological guidelines from the Cochrane Collaboration’s Musculoskeletal group [36] and Centre of Reviews and Dissemination (CRD) [37]; and is reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA) [38].…”

Elevated levels of interleukin-1β, interleukin-6, tumor necrosis factor-α and vascular endothelial growth factor in patients with knee articular cartilage injury

“…In recent years, many studies have found that osteoarthritis patients have immune abnormalities, and abnormal secretions of cytokines might damage cartilage function and metabolism[14,15]. In addition, aggravated gradual decomposition of cartilage matrix can bring irreversible injury to the joint structure of patients, which is manifested as the corresponding clinical symptoms, thus accelerating the progress of articular cartilage injury[16,17]. IL-1β, IL-6 and TNF-α are secreted from macrophages and immune cells, which mainly come from the lining cells of the synovial membrane.…”