Cross-cultural adaptation and implementation of Good Life with osteoarthritis in Denmark (GLA:D™): group education and exercise for hip and knee osteoarthritis is feasible in Canada

A M Davis; D Kennedy; R Wong; S Robarts; S T Skou; R McGlasson; L C Li; E Roos

doi:10.1016/j.joca.2017.11.005

Cross-cultural adaptation and implementation of Good Life with osteoarthritis in Denmark (GLA:D™): group education and exercise for hip and knee osteoarthritis is feasible in Canada

Osteoarthritis Cartilage. 2018 Feb;26(2):211-219. doi: 10.1016/j.joca.2017.11.005. Epub 2017 Nov 13.

Authors

A M Davis¹, D Kennedy², R Wong³, S Robarts⁴, S T Skou⁵, R McGlasson⁶, L C Li⁷, E Roos⁸

Affiliations

¹ Health Care and Outcomes Research, Krembil Research Institute, University Health Network and Institute of Health Policy, Management and Evaluation and Department of Physical Therapy, University of Toronto, Toronto, Canada. Electronic address: [email protected].
² Rehabilitation and Program Development, Sunnybrook Holland Orthopaedic & Arthritic Centre and Department of Physical Therapy, University of Toronto, Toronto, Canada; School of Rehabilitation Science, McMaster University, Hamilton, Canada.
³ Health Care and Outcomes Research, Krembil Research Institute, University Health Network, Toronto, Canada.
⁴ Clinical Supervisor, Hip and Knee Arthritis Program, Sunnybrook Holland Orthopaedic & Arthritic Centre, Toronto, Canada.
⁵ Research Unit for Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense, Denmark; Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark.
⁶ Bone and Joint Canada, Toronto, Canada.
⁷ Department of Physical Therapy, University of British Columbia, Arthritis Research Canada, Vancouver, Canada.
⁸ Research Unit for Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense, Denmark.

PMID: 29146385
DOI: 10.1016/j.joca.2017.11.005

Abstract

Objective: Adapt and evaluate the feasibility of implementing Good Life with osteoArthritis in Denmark (GLA:D^TM) in Canada for people with mild to severe hip/knee osteoarthritis.

Methods: Patients triaged to non-surgical management participated in two education sessions and 12 supervised, neuromuscular exercise classes. We used the RE-AIM implementation framework evaluating outcomes of Reach, Effectiveness/Efficacy, Adoption, Implementation and Maintenance. Patients completed surveys pre-program and at 3 months follow-up. Program fidelity was evaluated at four observations against a priori criteria. We conducted semi-structured interviews with therapists post-program.

Results: 72 patients consented to participate, 59 started the program and one withdrew on physician advice. The remaining 58 provided follow-up data. Mean age was 67 years; 78% were female and 52% had body mass index (BMI) >25. The effect of the program was demonstrated: 40% improvement in pain with 59% achieving a clinically important improvement of ≥2 points on the Numeric Pain Rating scale. Statistically significant improvement also occurred in the Hip disability/Knee injury and Osteoarthritis Outcome Score subscales. 24% reported increased physical activity. Program fidelity was demonstrated with all criteria met. Therapists emphasized that rolling recruitment allowed appropriate supervision and resulted in participants encouraging each other. 99% of participants indicated they benefitted from and were satisfied with the program and 90% reported using the knowledge daily. 52% were willing to pay >$250 Cdn for the program.

Conclusion: GLA:D^TM implementation was feasible in the Canadian context with results similar to those of >7,000 participants in Denmark. Implementation and evaluation of GLA:D^TM Canada is now occurring nationally.

Keywords: Cross-cultural adaptation; Education; Hip and knee osteoarthritis; Implementation feasibility study; Neuromuscular exercise; Non-surgical management.

Publication types

Evaluation Study
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Canada
Culturally Competent Care / methods*
Disability Evaluation
Exercise
Exercise Therapy / methods*
Feasibility Studies
Female
Follow-Up Studies
Humans
Male
Middle Aged
Osteoarthritis, Hip / physiopathology
Osteoarthritis, Hip / rehabilitation*
Osteoarthritis, Knee / physiopathology
Osteoarthritis, Knee / rehabilitation*
Pain Management / methods
Pain Measurement / methods
Patient Education as Topic / methods*
Program Evaluation