Six week exercise and education programme for weight-bearing joint pain at primary health care facilities
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Date
2021-11
Authors
Malebo, Malebo Kopano
Journal Title
Journal ISSN
Volume Title
Publisher
University of the Free State
Abstract
Background: Joint pain is a common cause of functional limitation and increased health expenditure among older people. The ageing population is increasing the prevalence of joint pain and the demand for care. Joint pain is prevalent globally, one in three individuals experience joint pain, and in South Africa, 24.48% of primary health care clinics patients experience joint pain. In adults over 65 years old in a rural context, 29.7% reported experiencing joint pain. Physiotherapists working in a primary health care context are required to treat many patients with joint pain in the absence of clear guidelines. In urban and peri-urban contexts, health education and exercise programmes have been shown to improve pain, quality of life and self-efficacy of individuals with joint pain. The study aimed to determine and compare the impact of six-week education and exercise intervention programme on female patients 50 - 70 years old living with weight-bearing joint pain for three months or longer in the Maluti-a-Phofung health sub-district receiving care at PHC Clinics. Method: A single-blind randomised controlled trial was conducted using convenience sampling. Following baseline measurement, participants were randomised into the intervention, workbook, and usual care groups. Data was collected using interviewer administered outcome measures and physical performance task battery. Demographic data was collected using a self-developed demographics questionnaire. Pain severity and pain interference data were collected using the brief pain Inventory short from. Self-efficacy data was collected using the chronic diseases self-efficacy scale. Quality of life data was collected using the EQ-5D-3L, and physical function data was collected using Physical Performance Task Battery. Data was collected at baseline and six weeks. A self-developed acceptability questionnaire to collect acceptability data for the intervention group was used at six weeks. Results: Forty-seven participants enrolled in the study with a median of three painful joints. The majority of the participants were obese and presented with hypertension. There was no statistically significant difference in the pain severity scores between the groups at baseline or six weeks. There was no statistically significant difference in the pain interference score at baseline, but there was a statistically significant change within the intervention group for pain severity (p=0.00) and workbook group for pain severity (p=0.02). There was a statistically significant change in the pain severity and pain inference score for the intervention and workbook group for change within groups. The was not statistically significant difference in self-efficacy at baseline but there was statistically significant improvement in self-efficacy for the intervention (p=0.02) group and workbook group (p=0.04) at six weeks. The was no statistically significant difference in quality of life at baseline but there was a statically significant change in the quality-of-life (p=0.00) VAS=90 IQR (85-9) perception in the intervention group. There was no statistically significant difference between groups in the physical performance task battery at baseline nor at six weeks but there was a statistically significant improvement in the physical performance task battery within the intervention and workbook groups. There was a statically significant change of the timed-six-minute walk test with an improvement of 66 meters in the intervention group. Conclusion: The impact of the intervention on the intervention group was to decrease pain severity and pain interference, improve quality of life, improve self-efficacy and to improve physical function. In the workbook group the programme improved pain severity and interference, improved self-efficacy, and improved physical function. The six-week intervention can be used to manage joint pain in primary health care clinics and the workbook group should be investigated further but provides a bases for the use of a short formats in remote primary health care clinics.
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Keywords
Dissertation (M.Sc. Physiotherapy))--University of the Free State, 2021, Joint pain, Musculoskeletal conditions, Non-communicable disease, Self-management, Self-efficacy, Exercise, Physical activity, Health education, Primary health care clinics, Female