The University of Oslo is closed and the public defence will be held as a video conference over Zoom.
The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.
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Digital Trial Lecture – time and place
Adjudication committee
- First opponent: Professor David Hunter, University of Sydney, Australia
- Second opponent: Associate Professor Martin van der Esch, University of Applied Sciences for Health Professionals, The Netherlands
- Third member and chair of the evaluation committee: Associate Professor Line Kildal Bragstad, University of Oslo
Chair of the Defence
Associate Professor Joachim Horn, University of Oslo
Principal Supervisor
Associate Professor Nina Østerås, University of Oslo
Summary
Well-recognized treatment guidelines recommend the use of patient information, exercise and weight management as first-line treatments to all patients with symptomatic hip and knee osteoarthritis (OA). A large and persistent evidence-practice gap exists with regard to these recommendations and the treatments received by people with hip and knee OA. Further, little is known about the specific exercise dose that most efficiently improves OA pain and function.
The aims of this thesis were to address management of hip and knee OA in primary care by evaluating existing evidence of exercise dose for hip OA and effects of a new model for OA care in Norwegian primary care.
The methods applied to address these aims were a systematic review with meta-analyses and a stepped-wedge cluster-randomized trial (SW-CRT) to evaluate the implementation of a structured OA care model in primary care, including patient information and exercise.
The results showed that land-based, supervised exercise programs for hip OA with high compliance to dose recommendations for healthy adults resulted in significantly greater improvements in pain and non-significantly greater improvement in self-reported physical function compared to exercise programs with uncertain compliance with these recommendations.
In the SW-CRT, the implementation strategy and intervention successfully improved OA patient uptake of the first-line treatments and access to physiotherapy. However, the strategy was less effective in providing exercise programs with sufficient dose and progression and in supporting patient adherence to the exercise program. The between-group difference in proportion of patients with large symptom- improvements was uncertain.
Additional information
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