An evidence-based walking program among older people with knee osteoarthritis: the PEP (participant exercise preference) pilot randomized controlled trial.
Study Goal
The researchers aimed to determine if assigning participants to their preferred walking program (supervised or unsupervised) improved adherence and clinical outcomes in older adults with knee osteoarthritis.
Results Summary
Participants assigned to their preferred walking program showed significantly higher adherence and improved stiffness (WOMAC) and functional status (Timed Up and GO Test) compared to those who did not receive their preference. The supervised group had higher adherence (60.7%) than the unsupervised group (43.1%).
Population
Older adults with a diagnosis of knee osteoarthritis (69 participants).
Effective Dosage
Not specified (based on Ottawa Panel guidelines).
Duration
9 months.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
supervised community-based walking program | increase | adherence to walking sessions | participants who expressed a preference for the supervised program and were assigned to it | 60.7 ± 12.3% | showed significantly higher adherence | #1 |
unsupervised walking program | increase | adherence to walking sessions | participants who expressed a preference for the unsupervised program and were assigned to it | 43.1 ± 12.1% | showed significantly higher adherence | #2 |
walking program (supervised or unsupervised) based on patient preference | decrease | level of stiffness evaluated with the WOMAC | adherent participants who obtained their preference | - | significant improvements were shown | #3 |
walking program (supervised or unsupervised) based on patient preference | improve | functional status assessed with the Timed Up and GO Test | adherent participants who obtained their preference | - | significant improvements were shown | #4 |
this approach (patient preference-based assignment to walking program) | increase | adherence to a community-based walking program | older adults susceptible to avoid or not properly engage in physical activity | - | promotes long-term adherence | #5 |
this approach (patient preference-based assignment to walking program) | no change | clinical benefits of walking | older adults susceptible to avoid or not properly engage in physical activity | - | ensuring the maintenance of clinical benefits | #6 |
Knee osteoarthritis is a common joint problem leading to an increase of pain and a loss of function in older individuals. The main objective of this study was to evaluate if a participant who was randomly assigned to his preferred group improved his adherence to an effective walking program compared to a participant who did not receive his preferred group. This was a 9-month pilot randomized clinical trial, based on a patient treatment preferences design. The 69 eligible participants had a diagnosis of knee osteoarthritis. Participants were randomized to one of two groups: a supervised community-based or unsupervised walking program, based on the Ottawa Panel guidelines. At 6 months, participants who expressed a preference, either for the supervised or unsupervised program, and who were assigned to their preferred choice of program showed significantly higher adherence to walking sessions (supervised 60.7 ± 12.3%, P < 0.0001; unsupervised 43.1 ± 12.1%, P = 0.03), compared to the participants who did not obtain their preferred choice of program. After 9 months, significant improvements were shown according to the level of stiffness evaluated with the WOMAC (P = 0.01) and the functional status assessed with the Timed Up and GO Test (P = 0.04), among the adherent participants who obtained their preference, as compared to those who did not receive their preference. We show this approach promotes long-term adherence to a community-based walking program, while ensuring the maintenance of clinical benefits of walking, among older adults susceptible to avoid or not properly engage in physical activity.