Top

BMC Musculoskeletal Disorders

Published in:

Open Access 01-12-2016 | Study protocol

The PLE²NO self-management and exercise program for knee osteoarthritis: Study Protocol for a Randomized Controlled Trial

Authors: Priscila Marconcin, Margarida Espanha, Flávia Yázigi, Pedro Campos

Published in: BMC Musculoskeletal Disorders | Issue 1/2016

Abstract

Background

International recommendations suggest exercise and self-management programs, including non-pharmacological treatments, for knee osteoarthritis (KOA) because they can benefit pain relief and improve function and exercise adherence. The implementation of a combined self-management and exercise program termed PLE²NO may be a good method for controlling KOA symptoms because it encourages the development of self-efficacy to manage the pathology. This study will assess the effects of a self-management and exercise program in comparison to an educational intervention (control program) on symptoms, physical fitness, health-related quality of life, self-management behaviors, self-efficacy, physical activity level and coping strategies.

Methods/Design

This PLE²NO study is a single-blinded, randomized controlled trial of elderly (aged above 60 yrs old) patients with clinical and radiographic KOA. The patients will be allocated into either an educational group (control) or a self-management and exercise group (experimental). All participants will receive a supplement of chondroitin and glucosamine sulfates. This paper describes the protocol that will be used in the PLE²NO program.

Discussion

This program has several strengths. First, it involves a combination of self-management and exercise approaches, is available in close proximity to the patients and occurs over a short period of time. The latter two characteristics are crucial for maintaining participant adherence. Exercise components will be implemented using low-cost resources that permit their widespread application. Moreover, the program will provide guidance regarding the effectiveness of using a self-management and exercise program to control KOA symptoms and improve self-efficacy and health-related quality of life.

Trial registration

NCT02562833 (09/23/2015)

Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part II. Arthritis Rheum. 2008;58(1):26–35. doi:10.1002/art.23176.CrossRefPubMedPubMedCentral

Sangha O. Epidemiology of rheumatic diseases. Rheumatology. 2000;39 suppl 2:3–12. doi:10.1093/rheumatology/39.suppl_2.3.CrossRefPubMed

Heidari B. Knee osteoarthritis prevalence, risk factors, pathogenesis and features: Part I. Caspian J Intern Med. 2011;2(2):205–12.PubMedPubMedCentral

Helmick CG, Felson DT, Lawrence RC, Gabriel S, Hirsch R, Kwoh CK, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part I. Arthritis Rheum. 2008;58(1):15–25. doi:10.1002/art.23177.CrossRefPubMed

Peat G, McCarney R, Croft P. Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care. Ann Rheum Dis. 2001;60(2):91–7. doi:10.1136/ard.60.2.91.CrossRefPubMedPubMedCentral

Bruyère O, Cooper C, Arden N, Branco J, Brandi M, Herrero-Beaumont G, et al. Can We Identify Patients with High Risk of Osteoarthritis Progression Who Will Respond to Treatment? A Focus on Epidemiology and Phenotype of Osteoarthritis. Drugs Aging. 2015;32(3):179–87. doi:10.1007/s40266-015-0243-3.CrossRefPubMedPubMedCentral

Lane NE, Brandt K, Hawker G, Peeva E, Schreyer E, Tsuji W, et al. OARSI-FDA initiative: defining the disease state of osteoarthritis. Osteoarthr Cartil. 2011;19(5):478–82. http://dx.doi.org/10.1016/j.joca.2010.09.013.CrossRefPubMed

Tanimura C, Morimoto M, Hiramatsu K, Hagino H. Difficulties in the daily life of patients with osteoarthritis of the knee: scale development and descriptive study. J Clin Nurs. 2011;20(5-6):743–53. doi:10.1111/j.1365-2702.2010.03536.x.CrossRefPubMed

Johnson VL, Hunter DJ. The epidemiology of osteoarthritis. Best Pract Res Clin Rheumatol. 2014;28(1):5–15. http://dx.doi.org/10.1016/j.berh.2014.01.004.CrossRefPubMed

10.

Branco JC, Rodrigues AM, Gouveia N, Eusébio M, Ramiro S, Machado PM et al. Prevalence of rheumatic and musculoskeletal diseases and their impact on health-related quality of life, physical function and mental health in Portugal: results from EpiReumaPt– a national health survey. RMD Open. 2016;2(1). doi:10.1136/rmdopen-2015-000166.

11.

McAlindon TE, Bannuru RR, Sullivan MC, Arden NK, Berenbaum F, Bierma-Zeinstra SM, et al. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthr Cartil. 2014;22(3):363–88. http://dx.doi.org/10.1016/j.joca.2014.01.003.CrossRefPubMed

12.

Hochberg MC, Altman RD, April KT, Benkhalti M, Guyatt G, McGowan J, et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res. 2012;64(4):465–74. doi:10.1002/acr.21596.CrossRef

13.

Fernandes L, Hagen KB, Bijlsma JWJ, Andreassen O, Christensen P, Conaghan PG, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann Rheum Dis. 2013. doi:10.1136/annrheumdis-2012-202745.PubMedCentral

14.

Goeppinger J, Armstrong B, Schwartz T, Ensley D, Brady TJ. Self-management education for persons with arthritis: Managing comorbidity and eliminating health disparities. Arthritis Care Res. 2007;57(6):1081–8. doi:10.1002/art.22896.CrossRef

15.

Goeppinger J, Lorig KR, Ritter PL, Mutatkar S, Villa F, Gizlice Z. Mail-delivered arthritis self-management tool kit: A randomized trial and longitudinal followup. Arthritis Care Res. 2009;61(7):867–75. doi:10.1002/art.24587.CrossRef

16.

Hansson EE, Jonsson-Lundgren M, Ronnheden AM, Sorensson E, Bjarnung A, Dahlberg LE. Effect of an education programme for patients with osteoarthritis in primary care--a randomized controlled trial. BMC Musculoskelet Disord. 2010;11:244. doi:10.1186/1471-2474-11-244.CrossRefPubMedPubMedCentral

17.

Kao M-J, Wu M-P, Tsai M-W, Chang W-W, Wu S-F. The effectiveness of a self-management program on quality of life for knee osteoarthritis (OA) patients. Arch Gerontol Geriatr. 2012;54(2):317–24. http://dx.doi.org/10.1016/j.archger.2011.05.018.CrossRefPubMed

18.

Wu S-FV, Kao M-J, Wu M-P, Tsai M-W, Chang W-W. Effects of an osteoarthritis self-management programme. J Adv Nurs. 2011;67(7):1491–501. doi:10.1111/j.1365-2648.2010.05603.x.CrossRefPubMed

19.

Lorig K, Holman H. Self-management education: History, definition, outcomes, and mechanisms. Ann Behav Med. 2003;26(1):1–7. doi:10.1207/S15324796ABM2601_01.CrossRefPubMed

20.

Lorig KR, Ritter PL, Laurent DD, Plant K. The internet-based arthritis self-management program: A one-year randomized trial for patients with arthritis or fibromyalgia. Arthritis Care Res. 2008;59(7):1009–17. doi:10.1002/art.23817.CrossRef

21.

Nuñez M, Nuñez E, Segur JM, Macule F, Quinto L, Hernandez MV, et al. The effect of an educational program to improve health-related quality of life in patients with osteoarthritis on waiting list for total knee replacement: a randomized study. Osteoarthr Cartil. 2006;14(3):279–85. http://dx.doi.org/10.1016/j.joca.2005.10.002.CrossRefPubMed

22.

Osborne RH, Buchbinder R, Ackerman IN. Can a disease-specific education program augment self-management skills and improve Health-Related Quality of Life in people with hip or knee osteoarthritis? BMC Musculoskelet Disord. 2006;7:1–10. doi:10.1186/1471-2474-7-90.CrossRef

23.

Yip YB, Sit JWH, Fung KKY, Wong DYS, Chong SYC, Chung LH, et al. Effects of a self-management arthritis programme with an added exercise component for osteoarthritic knee: randomized controlled trial. J Adv Nurs. 2007;59(1):20–8. doi:10.1111/j.1365-2648.2007.04292.x.CrossRefPubMed

24.

Barlow JH, Turner AP, Wright CC. A randomized controlled study of the Arthritis Self-Management Programme in the UK. Health Educ Res. 2000;15(6):665–80.CrossRefPubMed

25.

Coleman S, Briffa K, Conroy H, Prince R, Carroll G, McQuade J. Short and medium-term effects of an education self-management program for individuals with osteoarthritis of the knee, designed and delivered by health professionals: A quality assurance study. BMC Musculoskelet Disord. 2008;9:1–8. doi:10.1186/1471-2474-9-117.CrossRef

26.

Coleman S, McQuade J, Rose J, Inderjeeth C, Carroll G, Briffa NK. Self-management for osteoarthritis of the knee: Does mode of delivery influence outcome? BMC Musculoskelet Disord. 2010;11:56–61. doi:10.1186/1471-2474-11-56.CrossRefPubMedPubMedCentral

27.

Tattersall RL. The expert patient: a new approach to chronic disease management for the twenty-first century. Clin Med (London, England). 2002;2(3):227–9.CrossRef

28.

Lawn SBM. Capabilities for supporting prevention and chronic condition self-management: A resource for educators of primary health care professionals. Flinders University, Adelaide: Australian Government Department of Health and Ageing; 2009.

29.

Lorig KR, Sobel DS, Stewart AL, Brown Jr BW, Bandura A, Ritter P, et al. Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: a randomized trial. Med Care. 1999;37(1):5–14.CrossRefPubMed

30.

Jonhston S, Liddy C, Ives SM, Soto E. Literature Review on Chronic Disease Self-Management The Champlain Local Health Integration Network. 2008.

31.

Lorig KR, Sobel DS, Ritter PL, Laurent D, Hobbs M. Effect of a self-management program on patients with chronic disease. Eff Clin Pract. 2001;4(6):256–62.PubMed

32.

Lorig KR, Mazonson PD, Holman HR. Evidence suggesting that health education for self-management in patients with chronic arthritis has sustained health benefits while reducing health care costs. Arthritis Rheum. 1993;36(4):439–46.CrossRefPubMed

33.

Yip YB, Sit JWH, Wong DYS. A quasi-experimental study on improving arthritis self-management for residents of an aged people’s home in Hong Kong. Psychol Health Med. 2004;9(2):235–46.CrossRef

34.

Brady T, Murphy L, Beauchesne D, Bhalakia A, Chervin D, Daniels B, Greenberg M, House M, O’Colmain B. Executive Summary of ASMP/CDSMP Meta-Analyses. Centers for Disease Control and Prevention. 2011.

35.

Levy SS, Macera CA, Hootman JM, Coleman KJ, Lopez R, Nichols JF, et al. Evaluation of a multi-component group exercise program for adults with arthritis: Fitness and Exercise for People with Arthritis (FEPA). Disabil Health J. 2012;5(4):305–11. doi:10.1016/j.dhjo.2012.07.003.CrossRefPubMed

36.

Callahan LF, Mielenz T, Freburger J, Shreffler J, Hootman J, Brady T, et al. A randomized controlled trial of the people with arthritis can exercise program: symptoms, function, physical activity, and psychosocial outcomes. Arthritis Rheum. 2008;59(1):92–101. doi:10.1002/art.23239.CrossRefPubMed

37.

Callahan LF. Evaluation of Group and Self-Directed Formats of the Arthritis Foundation’s Walk With Ease Program. Arthritis Care Res. 2011;63(8):1098–107.CrossRef

38.

Jan M, Lin J, Liau J, Lin Y, Lin D. Investigation of clinical effects of high- and low-resistance training for patients with knee osteoarthritis: a randomized controlled trial. Phys Ther. 2008;88:427–36.CrossRefPubMed

39.

Salli A, Sahin N, Baskent A, Ugurlu H. The effect of two exercise programs on various functional outcome measures in patients with osteoarthritis of the knee: A randomized controlled clinical trial. Isokinet Exerc Sci. 2010;18(4):201–9.

40.

Ettinger Jr WH, Burns R, Messier SP, Applegate W, Rejeski WJ, Morgan T, et al. A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST). JAMA. 1997;277(1):25–31.CrossRefPubMed

41.

Maurer BT, Stern AG, Kinossian B, Cook KD, Schumacher Jr HR. Osteoarthritis of the knee: Isokinetic quadriceps exercise versus an educational intervention. Arch Phys Med Rehabil. 1999;80(10):1293–9. http://dx.doi.org/10.1016/S0003-9993(99)90032-1.CrossRefPubMed

42.

Penninx B, Messier S, Rejeski W, Williamson J, DiBari M, Cavazzini C, et al. Physical Exercise and the Prevention of Disability in Activities of Daily Living in Older Persons With Osteoarthritis. Am J Health Promot. 2003;17(3):217.

43.

Topp R, Woolley S, Hornyak Iii J, Khuder S, Kahaleh B. The effect of dynamic versus isometric resistance training on pain and functioning among adults with osteoarthritis of the knee. Arch Phys Med Rehabil. 2002;83(9):1187–95. http://dx.doi.org/10.1053/apmr.2002.33988.CrossRefPubMed

44.

Wang T-J, Belza B, Elaine Thompson F, Whitney JD, Bennett K. Effects of aquatic exercise on flexibility, strength and aerobic fitness in adults with osteoarthritis of the hip or knee. J Adv Nurs. 2007;57(2):141–52. doi:10.1111/j.1365-2648.2006.04102.x.CrossRefPubMed

45.

Huang M-H, Lin Y-S, Yang R-C, Lee C-L. A comparison of various therapeutic exercises on the functional status of patients with knee osteoarthritis. Semin Arthritis Rheum. 2003;32(6):398–406. http://dx.doi.org/10.1053/sarh.2003.50021.CrossRefPubMed

46.

Yázigi F, Espanha M, Messier S. P. Knee Osteoarthritis and Obesity: Effectiveness of PICO Aquatic Exercise Program on Symptoms, Physical Fitness and Quality of Life. Oeiras: Universidade de Lisboa; 2014.

47.

Messier SP, Loeser RF, Miller GD, Morgan TM, Rejeski WJ, Sevick MA, et al. Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: The arthritis, diet, and activity promotion trial. Arthritis Rheum. 2004;50(5):1501–10. doi:10.1002/art.20256.CrossRefPubMed

48.

van Baar ME, Dekker J, Oostendorp R, Bijl D, Voorn T, Bijlsma J. Effectiveness of exercise in patients with osteoarthritis of hip or knee: nine months’ follow up. Ann Rheum Dis. 2001;60(12):1123–30. doi:10.1136/ard.60.12.1123.CrossRefPubMedPubMedCentral

49.

Gyurcsik NC, Brittain DR. Partial Examination of the Public Health Impact of the People with Arthritis Can Exercise (PACE®) Program: Reach, Adoption, and Maintenance. Public Health Nurs. 2006;23(6):516–22. doi:10.1111/j.1525-1446.2006.00591.x.CrossRefPubMed

50.

Bartels EM, Lund H, Hagen KB, Dagfinrud H, Christensen R, Danneskiold-Samsoe B. Aquatic exercise for the treatment of knee and hip osteoarthritis. Cochrane Database Syst Rev. 2007;(4):Cd005523. doi:10.1002/14651858.CD005523.pub2

51.

Lim J-Y, Tchai E, Jang S-N. Effectiveness of Aquatic Exercise for Obese Patients with Knee Osteoarthritis: A Randomized Controlled Trial. PM&R. 2010;2(8):723–31. http://dx.doi.org/10.1016/j.pmrj.2010.04.004.CrossRef

52.

Lu M, Su Y, Zhang Y, Zhang Z, Wang W, He Z, et al. Effectiveness of aquatic exercise for treatment of knee osteoarthritis : Systematic review and meta-analysis. Z Rheumatol. 2015;74(6):543–52. doi:10.1007/s00393-014-1559-9.CrossRefPubMed

53.

Yazigi F, Espanha M, Vieira F, Messier SP, Monteiro C, Veloso AP. The PICO project: aquatic exercise for knee osteoarthritis in overweight and obese individuals. BMC Musculoskelet Disord. 2013;14(1):320. doi:10.1186/1471-2474-14-320.CrossRefPubMedPubMedCentral

54.

Fransen M, McConnell S, HA R, Van der Esch M, Simic M, Bennell K. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2015;4:Cd004376. doi:CD004376.

55.

Uthman OA, van der Windt DA, Jordan JL, Dziedzic KS, Healey EL, Peat GM et al. Exercise for lower limb osteoarthritis: systematic review incorporating trial sequential analysis and network meta-analysis. BMJ. 2013;347. doi:10.1136/bmj.f5555

56.

Tanaka R, Ozawa J, Kito N, Moriyama H. Efficacy of strengthening or aerobic exercise on pain relief in people with knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Clin Rehabil. 2013;27(12):1059–71.CrossRefPubMed

57.

Bennell KL, Hinman RS. A review of the clinical evidence for exercise in osteoarthritis of the hip and knee. J Sci Med Sport. 2011;14(1):4–9. http://dx.doi.org/10.1016/j.jsams.2010.08.002.CrossRefPubMed

58.

Boutaugh ML. Arthritis Foundation community-based physical activity programs: Effectiveness and implementation issues. Arthritis Care Res. 2003;49(3):463–70. doi:10.1002/art.11050.CrossRef

59.

Callahan LF, Schoster B, Meier A, Mielenz T, DiMartino L. The People with Arthritis Can Exercise (PACE) Program: A Qualitative Evaluation of Participant Satisfaction. Prev Chronic Dis. 2005;2(3):A11.PubMedPubMedCentral

60.

Henrotin Y, Marty M, Mobasheri A. What is the current status of chondroitin sulfate and glucosamine for the treatment of knee osteoarthritis? Maturitas. 2014;79(4):487. doi:10.1016/j.maturitas.2014.04.015.CrossRef

61.

Wieland HA, Michaelis M, Kirschbaum BJ, Rudolphi KA. Osteoarthritis - an untreatable disease? Nat Rev Drug Discov. 2005;4(4):331–44. doi:10.1038/nrd1693.CrossRefPubMed

62.

Lee Y, Woo J-H, Choi S, Ji J, Song G. Effect of glucosamine or chondroitin sulfate on the osteoarthritis progression: a meta-analysis. Rheumatol Int. 2010;30(3):357–63. doi:10.1007/s00296-009-0969-5.CrossRefPubMed

63.

Bruyere O, Pavelka K, Rovati LC, Gatterová J, Giacovelli G, Olejarová M, et al. Total joint replacement after glucosamine sulphate treatment in knee osteoarthritis: results of a mean 8-year observation of patients from two previous 3-year, randomised, placebo-controlled trials. Osteoarthr Cartil. 2008;16(2):254–60. http://dx.doi.org/10.1016/j.joca.2007.06.011.CrossRefPubMed

64.

Zegels B, Crozes P, Uebelhart D, Bruyère O, Reginster JY. Equivalence of a single dose (1200 mg) compared to a three-time a day dose (400 mg) of chondroitin 4&6 sulfate in patients with knee osteoarthritis. Results of a randomized double blind placebo controlled study. Osteoarthr Cartil. 2013;21(1):22–7. http://dx.doi.org/10.1016/j.joca.2012.09.017.CrossRefPubMed

65.

Clegg DO, Reda DJ, Harris CL, Klein MA, O’Dell JR, Hooper MM, et al. Glucosamine, Chondroitin Sulfate, and the Two in Combination for Painful Knee Osteoarthritis. N Engl J Med. 2006;354(8):795–808. doi:10.1056/NEJMoa052771.CrossRefPubMed

66.

Fransen M, Agaliotis M. Glucosamine and chondroitin for knee osteoarthritis: a double-blind randomised placebo-controlled clinical trial evaluating single and combination regimens. 2015;74(5):851-8. doi:10.1136/annrheumdis-2013-203954

67.

Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175–91.CrossRefPubMed

68.

McKnight PE, Kasle S, Going S, Villanueva I, Cornett M, Farr J, et al. A comparison of strength training, self-management, and the combination for early osteoarthritis of the knee. Arthritis Care Res (Hoboken). 2010;62(1):45–53. doi:10.1002/acr.20013.CrossRef

69.

Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum. 1986;29(8):1039–49.CrossRefPubMed

70.

Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, et al. Development of criteria for the classification and reporting of osteoarthritis: Classification of osteoarthritis of the knee. Arthritis Rheum. 1986;29(8):1039–49. doi:10.1002/art.1780290816.CrossRefPubMed

71.

Ritter PL, Gonzalez VM, Laurent DD, Lorig KR. Measurement of pain using the visual numeric scale. J Rheumatol. 2006;33(3):574–80.PubMed

72.

Hughes SL, Seymour RB, Campbell R, Pollak N, Huber G, Sharma L. Impact of the fit and strong intervention on older adults with osteoarthritis. The Gerontologist. 2004;44(2):217–28.CrossRefPubMed

73.

Fiatarone MA, O’Neill EF, Ryan ND, Clements KM, Solares GR, Nelson ME, et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med. 1994;330(25):1769–75. doi:10.1056/nejm199406233302501.CrossRefPubMed

74.

Fisher NM, Pendergast DR, Gresham GE, Calkins E. Muscle rehabilitation: its effect on muscular and functional performance of patients with knee osteoarthritis. Arch Phys Med Rehabil. 1991;72(6):367–74.PubMed

75.

Lagally KM, Robertson RJ. Construct validity of the OMNI resistance exercise scale. J Strength Cond Res/National Strength & Conditioning Association. 2006;20(2):252–6. doi:10.1519/r-17224.1.

76.

Espanha M, Priscila M, Yázigi F, Marques A, Machado M, Campos P, et al. Guia para viver em PLENO: com menos dor e mais qualidade de vida. Lisboa: FMH-Ulisboa; 2015.

77.

Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16(4):494–502.CrossRefPubMedPubMedCentral

78.

Roos EM, Lohmander LS. The Knee injury and Osteoarthritis Outcome Score (KOOS): from joint injury to osteoarthritis. Health Qual Life Outcomes. 2003;1:64. doi:10.1186/1477-7525-1-64.CrossRefPubMedPubMedCentral

79.

Lorig KR, Stewart A, Ritter PL, González V, Laurent D, Lynch J. Outcome Measures for Health Education and Other Health Care Interventions. Thousand Oaks: Sage Publications; 1996.

80.

Pickard AS, Kohlmann T, Janssen MF, Bonsel G, Rosenbloom S, Cella D. Evaluating Equivalency Between Response Systems: Application of the Rasch Model to a 3-Level and 5-Level EQ-5D. Med Care. 2007;45(9):812–9. doi:10.1097/MLR.0b013e31805371aa.CrossRefPubMed

81.

Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–95. doi:10.1249/01.mss.0000078924.61453.fb.CrossRefPubMed

82.

Rutten A, Abu-Omar K. Prevalence of physical activity in the European Union. Soz Praventivmed. 2004;49(4):281–9.CrossRefPubMed

83.

Carver CS, Scheier MF, Weintraub JK. Assessing coping strategies: a theoretically based approach. J Pers Soc Psychol. 1989;56(2):267–83.CrossRefPubMed

84.

Carver CS. You want to measure coping but your protocol’s too long: consider the brief COPE. Int J Behav Med. 1997;4(1):92–100. doi:10.1207/s15327558ijbm0401_6.CrossRefPubMed

85.

Rikli RE, Jones CJ. The reliability and validity of a 6-minute walk test as a measure of physical endurance in older adults. J Aging Phys Act. 1998;6:363–75.

86.

Schlenk EA, Lias JL, Sereika SM, Dunbar-Jacob J, Kwoh CK. Improving Physical Activity and Function in Overweight and Obese Older Adults with Osteoarthritis of the Knee: A Feasibility Study. Rehabil Nurs. 2011;36(1):32–42. doi:10.1002/j.2048-7940.2011.tb00063.x.CrossRefPubMedPubMedCentral

87.

Escalante Y, García-Hermoso A, Saavedra JM. Effects of exercise on functional aerobic capacity in lower limb osteoarthritis: A systematic review. J Sci Med Sport. 2011;14(3):190–8. http://dx.doi.org/10.1016/j.jsams.2010.10.004.CrossRefPubMed

88.

Bohannon RW. Sit-to-stand test for measuring performance of lower extremity muscles. Percept Mot Skills. 1995;80(1):163–6. doi:10.2466/pms.1995.80.1.163.CrossRefPubMed

89.

Bohannon RW. Test-retest reliability of the five-repetition sit-to-stand test: a systematic review of the literature involving adults. J Strength Cond Res/National Strength & Conditioning Association. 2011;25(11):3205–7. doi:10.1519/JSC.0b013e318234e59f.CrossRef

90.

Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142–8.CrossRefPubMed

91.

Jones CJ, Rikli RE, Max J, Noffal G. The reliability and validity of a chair sit-and-reach test as a measure of hamstring flexibility in older adults. Res Q Exerc Sport. 1998;69(4):338–43. doi:10.1080/02701367.1998.10607708.CrossRefPubMed

92.

Rikli RE, Jones CJ. The development and validation of a functional fitness test for community-residing older adults. J Aging Phys Act. 1999;7:129–61.

93.

Cesari M, Kritchevsky SB, Newman AB, Simonsick EM, Harris TB, Penninx BW, et al. Added Value of Physical Performance Measures in Predicting Adverse Health-Related Events: Results from the Health, Aging, and Body Composition Study. J Am Geriatr Soc. 2009;57(2):251–9. doi:10.1111/j.1532-5415.2008.02126.x.CrossRefPubMedPubMedCentral

94.

Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39(4):412–23. doi:10.1093/ageing/afq034.CrossRefPubMedPubMedCentral

95.

Rose DJ. A Comprehensive Balance and Mobility Training Program. Champaign: Human Kinectics; 2003.

96.

Giampaoli S, Ferrucci L, Cecchi F, Lo Noce C, Poce A, Dima F, et al. Hand-grip strength predicts incident disability in non-disabled older men. Age Ageing. 1999;28(3):283–8.CrossRefPubMed

97.

Alley DE, Shardell MD, Peters KW, McLean RR, Dam TT, Kenny AM, et al. Grip strength cutpoints for the identification of clinically relevant weakness. J Gerontol A BiolSci Med Sci. 2014;69(5):559–66. doi:10.1093/gerona/glu011.CrossRef

98.

Hurst H, Bolton J. Assessing the clinical significance of change scores recorded on subjective outcome measures. J Manip Physiol Ther. 2004;27(1):26–35. doi:10.1016/j.jmpt.2003.11.003.CrossRef

99.

Borg G. Borg’s Perceived Exertion and Pain Scale. Champaign: Human Kinetics; 1998.

Title: The PLE2NO self-management and exercise program for knee osteoarthritis: Study Protocol for a Randomized Controlled Trial
Authors: Priscila Marconcin
Margarida Espanha
Flávia Yázigi
Pedro Campos
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2016
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-016-1115-7

At a glance: The STEP trials

Springer Medicine

The PLE²NO self-management and exercise program for knee osteoarthritis: Study Protocol for a Randomized Controlled Trial

Abstract

Background

Methods/Design

Discussion

Trial registration

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods/Design

Discussion

Trial registration

Please log in to get access to this content

Other articles of this Issue 1/2016

Protocol for evaluating the effects of a therapeutic foot exercise program on injury incidence, foot functionality and biomechanics in long-distance runners: a randomized controlled trial

Efficacy of tranexamic acid in reducing allogeneic blood products in adolescent idiopathic scoliosis surgery

PREPARE: Pre-surgery physiotherapy for patients with degenerative lumbar spine disorder: a randomized controlled trial protocol

A comparative, retrospective study of peri-articular and intra-articular injection of tranexamic acid for the management of postoperative blood loss after total knee arthroplasty

The impact of incidental durotomy on the outcome of decompression surgery in degenerative lumbar spinal canal stenosis: analysis of the Lumbar Spinal Outcome Study (LSOS) data—a Swiss prospective multi-center cohort study

The influence of calcitonin gene-related peptide on markers of bone metabolism in MG-63 osteoblast-like cells co-cultured with THP-1 macrophage-like cells under virtually osteolytic conditions