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Effect of combined exercise training and behaviour change counselling versus usual care on physical activity in patients awaiting hip and knee arthroplasty: A randomised controlled trial


Williams, AD and O'Brien, J and Mulford, J and Mathew, R and Thapa, DK and Hamilton, K and Cheney, M and Schmidt, M and Wu, S and Bird, M-L, Effect of combined exercise training and behaviour change counselling versus usual care on physical activity in patients awaiting hip and knee arthroplasty: A randomised controlled trial, Osteoarthritis and Cartilage Open, 4, (4) Article 100308. ISSN 2665-9131 (2022) [Refereed Article]

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Copyright Statement

2022. The Authors. Published by Elsevier Ltd on behalf of Osteoarthritis Research Society International (OARSI). This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License ( which permits non-commercial use, reproduction, and distribution of the work without further permission provided the original work is attributed.

DOI: doi:10.1016/j.ocarto.2022.100308


Objective: This study aimed to determine if a novel intervention that combined individualised exercise training with behaviour change counselling based on Health Action Process Approach (HAPA) constructs could elicit long-term increase in physical activity (PA) and reduce comorbidity development among people requiring hip or knee arthroplasty.

Method: A pre-registered two arm, parallel group, randomised controlled trial comparing the effect of a 12-week individualised exercise program combined with behavioural counselling delivered by accredited exercise physiologists, versus usual care to Osteoarthritis (OA) patients on public surgery waitlists. Participants were followed up at 6 months after baseline (pre-surgery) and again at 6 months post-surgery. Within and between group differences in post-surgery PA (as measured by ActivPal accelerometer), pain, function, quality of life, HAPA-based behavioural and psychological constructs, and health risk factors were analysed.

Results: 63 participants (34 Female; Mean age ​= ​66.4 ​ ​7.2 ​yrs) consented to participate in this study. At 6 months post baseline and 6 months post-surgery there were significant improvements in PA, pain, function, and quality of life, however there were no significant differences in the between group responses. Significant between group changes were observed in several psychological constructs related to volition at 6 months post baseline; however, these had disappeared by 6 months post-surgery.

Conclusions: An exercise program and HAPA guided counselling intervention can improve psychological constructs related to exercise behaviour; however, these did not result in significant between group changes in PA at the timepoints measured. Further research with larger sample size is required.

Item Details

Item Type:Refereed Article
Keywords:osteoarthritis, health action process approach, exercise, behaviour change, waitlist
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Rheumatology and arthritis
Objective Division:Health
Objective Group:Provision of health and support services
Objective Field:Allied health therapies (excl. mental health services)
UTAS Author:Williams, AD (Associate Professor Andrew Williams)
UTAS Author:O'Brien, J (Dr Jane O'Brien)
UTAS Author:Cheney, M (Mr Michael Cheney)
UTAS Author:Schmidt, M (Mr Matthew Schmidt)
UTAS Author:Bird, M-L (Dr Marie-Louise Bird)
ID Code:153847
Year Published:2022
Deposited By:Health Sciences
Deposited On:2022-10-11
Last Modified:2022-12-11
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