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Challenges With Strengthening Exercises for Individuals With Knee Osteoarthritis and Comorbid Obesity: A Qualitative Study With Patients and Physical Therapists
Author(s) -
Lawford Belinda J.,
Bennell Kim L.,
Allison Kim,
Schwartz Sarah,
Hinman Rana S.
Publication year - 2022
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.24439
Subject(s) - medicine , physical therapy , osteoarthritis , randomized controlled trial , psychological intervention , physical medicine and rehabilitation , obesity , knee pain , qualitative research , alternative medicine , psychiatry , surgery , social science , pathology , sociology
Objective To explore challenges associated with implementing a home‐based strengthening exercise program for individuals with knee osteoarthritis and comorbid obesity. Methods This is a qualitative study embedded within a randomized controlled trial comparing 2 home‐based strengthening programs (weight‐bearing functional exercise versus non–weight‐bearing quadriceps strengthening exercise) for individuals with knee osteoarthritis and comorbid obesity. Patients in both exercise programs attended 5 consultations with a physical therapist and undertook a home‐based exercise program for 12 weeks. After trial completion, semistructured individual telephone interviews were conducted with 22 patients and all 7 physical therapists who delivered trial interventions. Interviews were recorded, transcribed verbatim, and thematically analyzed using an inductive approach. Results Three themes arose: 1) psychological challenges (false assumptions about exercise; fear of pain; disliking exercise; mental effort of the weight‐bearing functional program; underestimating capability); 2) physical challenges (complexity of the weight‐bearing functional program; cuff weights and straight leg raise being problematic in non–weight‐bearing quadriceps program; other health conditions); and 3) overcoming challenges (incentives to exercise; accountability; education and reassurance; tailoring the exercise program). Conclusion Patients and physical therapists experienced numerous psychological and physical challenges to exercise, including a fear of pain, having false assumptions about exercise, difficulties with exercise performance, application of cuff weights, and adverse impacts of other health conditions.