Benefits of a transtheoretical model‐based program on exercise adherence in older adults with knee osteoarthritis: A cluster randomized controlled trial

Benefits of a transtheoretical model-based exercise program on exercise adherence (primary outcome) and secondary outcomes (self-efficacy, decisional balance, knee osteoarthritis symptoms, and physical function) were assessed among older adults with knee osteoarthritis.A two-arm, superiority, assessor-blinded, cluster randomized trial with randomization at the community level.Participants were recruited from 14 communities in Beijing between April - October 2018 (N = 189). The intervention was a 24-week transtheoretical model-based exercise program and the control group underwent a non-theory-based exercise program. Exercise adherence was collected every 4 weeks and secondary outcomes were measured at baseline, 12 weeks, and 24 weeks. An independent t test and repeated-measures ANOVA were the main statistical tests.Most participants were women (92.5%), married (81.4%), with high-school education (36.0%), with both knees affected (50.3%), and did not make use of a walker (93.8%). There were no significant differences between groups in any of the outcome measures at baseline. Repeated-measures ANOVA indicated that there was a significant difference in the trend of adherence scores between the two groups from 0-24 weeks. The independent t test showed that scores in the intervention group were significantly better than in the control group at 16, 20, and 24 weeks. Improvements in the intervention group were also significantly greater in all secondary outcomes than in the control group.A theory-based exercise program could improve exercise adherence, self-efficacy, decisional balance, knee osteoarthritis symptoms, and physical functioning in older adults with knee osteoarthritis.Chinese Clinical Trials Registry number ChiCTR1800015458. Registered 31 March 2018.The 24-week theory-based exercise program could improve exercise adherence, self-efficacy, decisional balance, symptoms of knee osteoarthritis, and physical functioning in older adults with knee osteoarthritis. The theory-based exercise program could help older adults with knee osteoarthritis to improve their symptoms and knee function.目的: 在膝骨关节炎老年患者中评估基于跨理论模型的锻炼方案对于坚持锻炼表现(主要效果)和次要效果(自我效能、决策平衡、膝骨性关节炎症状和身体机能)的益处。 设计: 评估员社区级盲选的两个优势治疗组群的随机抽样试验。 方法: 2018年4月至10月在北京市14个社区招募受访者(N = 189)。介入治疗为24周跨理论模型锻炼计划,对照组则进行不基于理论的锻炼计划。每4周收集一次坚持锻炼数据,并在基线、12周和24周测量次要效果。独立的t检验和重复测量的方差分析是主要的统计检验。 结果: 绝大多数受访者为女性(92.5%),已婚(81.4%),受过高中教育(36.0%),双膝均受影响(50.3%),不使用助行器(93.8%)。在基线位置,两组的任何效果指标均无显著差异。根据重复测量方差分析表明,两组在0-24周内的坚持锻炼得分趋势存在显著差异。独立t检验显示,干预组在16、20和24周时的得分显著优于对照组。并且干预组比对照组在所有次要效果方面的改善也明显更大。 结论: 基于理论的锻炼计划可以改善膝骨关节炎老年患者的坚持锻炼表现、自我效能、决策平衡、膝骨关节炎症状和身体技能。 试验注册: 中国临床试验注册号:ChiCTR1800015458。 注册日期: 2018年3月31日。 影响: 基于理论的24周训练计划可以改善膝骨关节炎老年患者的坚持锻炼表现、自我效能、决策平衡、膝骨关节炎症状和身体技能。这项基于理论的锻炼计划可以帮助患有膝骨关节炎老年患者改善症状和膝关节功能。.