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Exercise adherence improving long-term patient outcome in patients with osteoarthritis of the hip and/or knee.

Pisters, M.F., Veenhof, C., Schellevis, F.G., Twisk, J.W., Dekker, J., Bakker, D.H. de. Exercise adherence improving long-term patient outcome in patients with osteoarthritis of the hip and/or knee. Arthritis Care and Research: 2010, 62(8), p. 1087-1094.
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OBJECTIVE: To determine the effect of patient exercise adherence within the prescribed physical therapy treatment period and after physical therapy discharge on patients' outcome on pain, physical function and patient self-perceived effect in individuals with osteoarthritis (OA) of the hip and/or knee. METHODS: Prospective observational follow-up study, in which 150 patients with OA of the hip and/or knee receiving exercise therapy were followed 60 months. Data were obtained from a randomized controlled trial, with assessments at baseline, 3, 15, and 60 months follow-up. The association between exercise adherence and patients' outcome on pain, physical function and self-perceived effect was examined using generalized estimating equations (GEE) analyses. RESULTS: Adherence to recommended home exercises and being more physically active was significantly associated with better treatment outcome on pain, self-reported physical function, physical performance and self-perceived effect. The association between adherence and outcome was consistent over time. Adherence to home activities was only associated with better self-perceived effect. CONCLUSION: Better adherence to recommended home exercises as well as being more physically active improves the long-term effectiveness of exercise therapy in patients with osteoarthritis of the hip and/or knee. Both within and after the treatment period better adherence is associated with better patients' outcome on pain, physical function, and self-perceived effect. Since exercise adherence declines over time, future research should focus on how exercise behavior can be stimulated and maintained in the long-term. (aut. ref.)