How to Increase Physical Activity in People with Knee Osteoarthritis——Evidence from a Systematic Review
Objective:To compare the effect of interventions on physical activity in people with knee osteoarthritis(KOA),and to summarize and assess the behavior change techniques(BCT)used in interventions.Methods:Six databases were searched from January 2000 to February 2023,to collect randomized controlled trials investigating interventions about physical activity behavior change in KOA patients.The coding of BCTs was based on the behavior change technique taxonomy.Associations between the number of BCTs used and the outcome were examined using one-way ANOVA.The potential contribution of BCT to physical activity was evaluated using the effective ratio(ER).Meta-analysis was performed by using Stata 16.0 software.Results:Eighteen studies involving 2 347 KOA patients were included.The number of BCTs used between different interventions was insignificant."Action planning"and"Instruction on how to perform a behavior"are the core components of physical activity behavior change interventions.The highest ER for BCTs is"Information about health consequences"(ER=8),followed by"Restructuring the physical environment","Adding objects to the environment"(ER=7),and"Social support(unspecified)"(ER=4.5).Meta-analysis demonstrated that various interventions can significantly increase physical activity in people with KOA.In the follow-up evaluation with 3 to 6 months,only the mixed interventi*on had a significant long-term promoting effect on physical activity(SMD=0.21,95%CI 0.03-0.39,P=0.02).Conclusion:Mixed intervention can effectively promote long-term changes in physical activity behavior in KOA patients.Due to the limitation of the number of studies included,the above findings need to be validated by more high-quality follow-up studies.
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