"I feel more confident": a mixed methods evaluation of the influence of Good Life with osteoarthritis Denmark (GLA:D®) on physical activity participation, capability, barriers, and facilitators in people with knee osteoarthritis.
Emily C Bell, Paul O'Halloran, Marcella F Pazzinatto and 5 others
PMID 39298800WHAT IT FOUND
GLA:D® reduced fear of knee damage and improved confidence and function, but physical activity participation did not increase.
Therapists should not assume improved confidence translates to more activity; address persistent pain, motivation, and environmental barriers separately.
Key findings
01The proportion of participants classified as 'more active' did not change significantly from baseline to 3 months or 12 months.
02Fear of knee damage decreased significantly from 50% at baseline to 5% at 3 months, while confidence to manage the condition remained high.
03All Knee injury and Osteoarthritis Outcome Score subscales improved at 3 and 12 months, with knee-related quality of life reaching the minimal important change threshold at 12 months.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study used a self-reported measure (UCLA scale) for physical activity, which is subject to recall and responder bias. Seven of the nineteen interview participants were known to the interviewer, which may have biased their responses. Participants were recruited from a clinical trial and had no out-of-pocket expenses, so findings may not reflect the attitudes of people who must pay for such programs. The cut-off for 'more active' was arbitrary, and other definitions might yield different results.
Declared interests
Three authors are program leads for GLA:D® Australia, a not-for-profit initiative, and their institution has received payment for training practitioners.
The easy way to misread this
Do not interpret the high confidence scores and reduced fear as evidence that the program successfully increased physical activity. The study found that while patients felt more capable and less afraid, their actual participation in physical activity did not increase significantly at 3 or 12 months.