The Effectiveness of Behavioral Graded Activity in Patients With Osteoarthritis of the Hip and/or Knee

Summary

We performed a randomized controlled trial to study the effectiveness of Behavioral graded activity (BGA) in patients with OA of the hip or knee. It was hypothesised that in the long term BGA results in less pain, less limitations in activities, and better patient global assessment (i.e. the effect of treatment perceived by patients themselves), compared to usual care of physiotherapists (UC). UC was operationalized as physiotherapeutic care according to the Dutch physiotherapy guideline for patients with hip and/or knee OA. It was also investigated whether specific subgroups of patients benefited more from BGA and which factors influenced the success of BGA-treatment. Also, it will be investigated whether differences exist in exercise adherence and whether there is a relationship between exercise adherence and long-term effectiveness.

Conditions

• Osteoarthritis

Interventions

BEHAVIORAL

Behavioral graded activity

The intervention is directed at increasing the level of activities in a time-contingent way, with the goal to integrate these activities in the daily living of the patients. The intervention is performed by physical therapists in primary care, on individual basis. Treatment period of maximal 12 weeks (with maximal 18 sessions), followed by 5 pre-set boostermoments with a maximum of 7 sessions (respectively in week 18, 25, 34, 42, and 55).

OTHER

Exercise therapy

Treatment according to the Dutch physiotherapy guideline for patients with osteoarthritis of hip and/or knee. This guideline consists of general recommendations, emphasizing provision of information and advice, exercise therapy, and encouragement of a positive coping with the complaints. The treatment consisted of a maximum of 18 sessions within a period of 12 weeks. The treatment could be discontinued within the 12 week period if, according to the physiotherapists, all treatment goals were achieved.

Sponsors & Collaborators

• Amsterdam UMC, location VUmc

  collaborator OTHER

• UMC Utrecht

  collaborator OTHER

• Maastricht University

  collaborator OTHER

• Radboud University Medical Center

  collaborator OTHER

• Netherlands Instititute for Health Services Research

  lead OTHER

Principal Investigators

• Joost Dekker, PhD · VU Medical Center Amsterdam, The Netherlands

• Johannes WJ Bijlsma, PhD, MD · UMC Utrecht, The Netherlands

• Cindy Veenhof, PhD · NIVEL, Utrecht, The Netherlands

• Cornelia HM van den Ende, PhD · St Maartenskliniek, Nijmegen, The Netherlands

• Martijn FP Pisters, MSc · NIVEL, Utrecht, The Netherlands

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

50 Years

Max Age

80 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2001-05-31

Completion

2008-05-31

Countries

• Netherlands

Study Locations