The Active with OsteoArthritis (AktivA) Physiotherapy Implementation Model: A Patient Education, Supervised Exercise and Self-Management Program for Patients with Mild to Moderate Osteoarthritis of the Knee or Hip Joint. A National Register Study with a Two-Year Follow-Up

Abstract

Background: Recent systematic reviews and international guidelines recommend patient education, exercises, and weight control (if overweight) as first-line treatment for patients with hip or knee osteoarthritis (OA). The Active with osteoArthritis (AktivA) program is a physiotherapy model for the implementation of these guidelines into clinical primary care practice. The purpose of the present study was to evaluate the long-term effects of and adherence to the AktivA program for patients with mild to moderate knee or hip OA. Methods: The AktivA program includes three modules: a physiotherapy certification course, a patient education and exercise program and an electronic quality register. An electronic questionnaire including questions about, pain, quality of life, physical activity, self-efficacy and satisfaction with the AktivA program are sent to the participants at inclusion and after 3, 12 and 24 months. A linear mixed model for repeated measurements was used to assess the difference between the follow-up times. Results: Until January 2020, 6245 patients were included in the register. The response rates were 98%, 86% and 63% at 3, 12 and 24 months, respectively. After participating in the AktivA program, the patients reported decreased pain and increased health-related and disease-specific quality of life at three months and the positive effect was maintained up to two years after inclusion. The proportion of patients reporting to be inactive or having a low physical activity level was reduced from 43% to 22%. After two years, more than 80% of the participants reported to use what they have learned from the AktivA program at least once a week. Conclusions: Two years after inclusion in the AktivA physiotherapy program, the patients still report reduced pain, increased quality of life and higher activity levels.

Muscle Strength and Osteoarthritis Progression After Surgery or Exercise for Degenerative Meniscal Tears: Secondary Analyses of a Randomized Trial

“…There was no patient involvement in the planning or conduct of the study, but user involvement was included in implementation of the exercise therapy program. User experiences and results from the OMEX trial are disseminated to clinicians and patients through AktivA, a nationally implemented osteoarthritis treatment program (29).…”

Knee and hip osteoarthritis are more alike than different in baseline characteristics and outcomes: a longitudinal study of 32,599 patients participating in supervised education and exercise therapy

“…This is the first large scale study to compare clinical characteristics and one of the first to separately report change in outcomes in patients with knee or hip OA treated in primary care 22,23 . In addition to the commonly reported treatment results for pain and function we also present data on joint-and generic health-related QOL and walking speed.…”

Development of an internet-delivered cognitive behavioral therapy program for use in combination with exercise therapy and education by patients at increased risk of chronic pain following total knee arthroplasty

“…Our research team aimed to take these results one step further and develop an evidence-based and internet-delivered CBT (iCBT) program for all OA patients who are candidates for TKA, but specifically targeted for patients less likely to benefit from standard TKA treatment. The program was designed to be combined with an exercise therapy and education program based on AktivA [ 46 ], consisting of a 90-min patient education session followed by exercise therapy twice a week for 12 weeks. To support patients and enhance the treatment’s effects, specially trained physiotherapists will also serve as patient mentors throughout the program.…”