Abstract Osteoarthritis (OA) is the most common musculoskeletal disorder affecting Australians and is the leading cause of pain and disability in the country. There is no known cure for OA, but pharmacological and non-pharmacological treatments can relieve symptoms and improve quality of life for OA sufferers: two of these are glucosamine sulphate (GS) and physical activity. Little is known about physical activity behavior and the correlates of physical activity participation among Australians with OA, or about the benefits of combining physical activity and GS for the management of OA. More generally, there is little information on the treatments used by OA sufferers in Australia. The first main aim of this thesis was to describe OA symptoms in people with hip or knee OA; their use of treatments for these symptoms; their health status; their current, past and future participation in physical activities; and their perceptions that could influence physical activity participation (Study 1). The second main aim was to compare the effectiveness of different frequencies and durations of walking, combined with GS intake, for reducing symptoms of OA and improving well-being in people with hip or knee OA (Study 2). Descriptive study (Study 1) A questionnaire was mailed to 2200 members of the Arthritis Queensland Foundation who lived in the Brisbane environs. Of these, 588 participants with hip or knee OA completed the survey. The most common treatments being used to manage osteoarthritic symptoms were weight loss (57%), range of motion exercises (56%), and strengthening exercises (49%). The most popular pharmacological treatments were glucosamine and/or chondroitin (54%) and anti-inflammatory medications (40%). Paracetamol (73%), topical liniment rubs (45%) and anti-inflammatory gels (35%) were the most commonly used ‘as needed’ medications. Most participants had fair to good health (68%). Many reported moderate levels of anxiety and depression as well as other health problems. Hypertension was the most common health problem (43.3%). Twenty-five percent reported that health problems were preventing them from walking, and 33% reported that health problems were preventing them from doing other exercises. Fifty-nine percent were meeting Australian physical activity guidelines (30 minutes of moderate-intensity physical activity most days of the week). Participants reported taking part in a wide range of sports and exercises, walking being the most common. They had moderate levels of self-efficacy for, and perceived many health benefits from being physically active, but perceived a moderate number of barriers to being active. Significant associations between past participation in sports and current OA symptoms were only found for men (p < 0.05), with past participation in Australian Rules football, basketball, soccer, skiing or volleyball associated with more severe symptoms in men. Feasibility study (Study 2) Thirty-six participants were given GS for 18 weeks. Starting in Week 6, they also participated in the 12-week Stepping Out walking program (after being randomly assigned to walk 3 or 5 days each week). Assessments were conducted at baseline, at Weeks 6, 12, and 18 during the intervention, and at a final follow-up during Week 24 of the study. Primary outcome measures were WOMAC pain, stiffness, physical function, and total scores and time to complete a self-paced step test, an objective measure of physical function. Comparisons were made between groups and between assessment weeks. As the data were not normally distributed, non-parametric techniques were used. Given that the study was a feasibility study, data were analysed on a per protocol basis. No significant between-group differences were found at any assessment week for the primary outcome measures. Therefore, changes between assessments were examined for the two groups combined. After 6 weeks of GS intake, WOMAC stiffness (p = 0.01) and physical function scores (p = 0.05) improved, as did physical function, measured objectively (p < .001). Between Weeks 6 and 12, when participants were asked to increase their daily steps over their current steps to an extra 1500-3000 per day, physical activity minutes increased (p = 0.01), and improvements were found for WOMAC pain (p = 0.03), WOMAC physical function (p = 0.03), and objectively-measured physical function (p < .001). Between Weeks 12 and 18, when participants were instructed to increase their daily steps by 6000 from baseline, physical activity minutes increased (p < .001), and further improvements were found for objectively-measured physical function (p < .001). During the follow up between Week 18 and 24, physical activity minutes decreased (p = 0.01) while objectively-measured physical function improved (p < .001). Both studies add to the body of literature on the management of OA of the hip and knee. Study 1 provides information about OA sufferers’ use of over-the-counter medications and their adoption of self-management strategies, information not routinely available from other sources, while Study 2 provides preliminary evidence for the walking ‘dose’ appropriate to relieve OA symptoms and on the effects of difference ‘doses’ on OA symptoms.
| Identifer | oai:union.ndltd.org:ADTP/253968 |
| Creators | Norman Ng |
| Source Sets | Australiasian Digital Theses Program |
| Detected Language | English |
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