Physical activity in patients with osteoarthritis: determinants of avoidance of physical activity and predictors of physical activity decline after discharge from physiotherapy exercise therapy.

Abstract Objective: To describe the course of patients’ level of physical activity after discharge from physiotherapy exercise therapy and to identify predictors of physical activity decline after discharge from physiotherapy exercise therapy in patients with osteoarthritis of the knee, focussing on potential individual, psychological and illness-related predictors. Methods: Data for this observational study were obtained from a randomized clinical trial comparing the effectiveness of a behavioural graded activity program and usual exercise therapy treatment according to the Dutch guidelines in patients with knee osteoarthritis. Assessments took place at baseline, 13, and 65 weeks follow-up. The relationship between physical activity decline after discharge from physiotherapy exercise therapy and potential individual, psychological and illness-related predictors was assessed using univariate and multiple logistic regression analyses. Results: At 65 weeks follow-up, the amount of physical activity declined in 44 % of patients with more than 60 minutes compared to the amount of physical activity measured at discharge from physiotherapy exercise therapy. The decrease of physical activity was substantial but not significant. Multiple logistic regression analyses showed that male gender, a higher number of coexisting disorders and a shorter duration of complaints are predictors of physical activity decline after discharge from physiotherapy exercise therapy. Conclusion: A large part of patients decline in amount of physical activity after discharge from physiotherapy exercise therapy. Male gender, a higher number of coexisting disorders and a shorter duration of complaints were in some extent identified as predictors of the course of physical activity decline. If needed, clinicians can adjust management strategies to prevent patients from physical activity decline after physiotherapy exercise therapy, thereby improving the long-term effectiveness of physiotherapy exercise therapy