Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jun 23, 2020
Date Accepted: Aug 17, 2020
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Behaviour change text messages for home exercise adherence in knee osteoarthritis: A randomised trial
ABSTRACT
Background:
Exercise is a core recommended treatment for knee OA, yet adherence declines particularly following cessation of clinician supervision.
Objective:
The objective was to evaluate whether a 24-week short message service (SMS) intervention improves adherence to unsupervised home exercise in people with knee OA and obesity.
Methods:
A two group, superiority randomized controlled trial in a community setting was performed. Participants were 110 people aged 50 years or older with knee OA and body mass index ≥30 kg/m2 who had undertaken a 12-week physiotherapist-supervised exercise program as part of a preceding clinical trial. Both groups were asked to continue their home exercise program unsupervised three times/week for 24-weeks and were randomly allocated to a behaviour change theory-informed, automated, semi-interactive SMS intervention addressing exercise barriers and facilitators or to control (no SMS). Primary outcomes were self-reported home exercise adherence at 24 weeks measured by i) Exercise Adherence Rating Scale Section B (EARS; 0-24, higher indicating greater adherence) and ii) number of days exercised in past week (0-3). Secondary outcomes included self-rated adherence (numeric rating scale), knee pain, physical function, quality-of-life, global change, physical activity, self-efficacy, pain catastrophising and kinesiophobia.
Results:
99 (90%) participants completed both primary outcomes. At 24 weeks, the SMS group reported higher EARS scores (mean (standard deviation) 16.5 (6.5) vs 13.3 (7.0); mean (95% confidence interval) difference 3.1 (0.8, 5.5), P=.01) and more days exercised in the past week (1.8 (1.2) vs 1.3 (1.2); mean (95% CI) difference 0.6 (0.2, 1.0), P=.01) than the control group. There was no evidence of between group differences in secondary outcomes.
Conclusions:
An SMS program increased self-reported adherence to unsupervised home exercise in people with knee OA and obesity, although this did not translate into improved clinical outcomes. Clinical Trial: Prospectively registered (Australian New Zealand Clinical Trials Registry#12617001243303)
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