The Effects of a Knitting Program on Osteoarthritis Symptoms in Elderly Women
The Effects of an 8-week Knitting Program on Osteoarthritis Symptoms in Elderly Women: A Pilot Randomized Controlled Trial
This pilot randomized controlled trial (RCT) studies the adherence and clinical effectiveness of a knitting program in older females suffering from hand osteoarthritis (HOA) to evaluate the acceptability of this intervention and assess the feasibility of a larger-scale RCT.
It is a single-blind, two-arm pilot RCT with a parallel group design with 40 participants (20 control, 20 experimental). Control participants are given an educational pamphlet and assigned to a waiting list. The knitting program (-8-week duration) has two components: bi-weekly 20-minute group knitting sessions and 20-minute home daily knitting on the 5 remaining weekdays. Measures include knitting adherence (implementation outcomes) as well as stiffness, pain, functional status, hand physical activity level, patient's global impression of change, health-related quality of life, self-efficacy, and grip strength (clinical outcomes measured throughout the 8-week program and 4 weeks after the intervention).
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Background: Exercise therapy is effective in reducing symptoms and disability associated with hand osteoarthritis (HOA) but has low adherence. An intervention consisting in a meaningful occupation, such as knitting, may improve adherence to treatment. This pilot randomized controlled trial (RCT) studies the adherence and clinical effectiveness of a knitting program in older females suffering from HOA to evaluate the acceptability of this intervention and assess the feasibility of a larger-scale RCT.
Methods: Single-blind, two-arm pilot RCT with a parallel group design with 40 participants (20 control, 20 experimental). Control participants are given an educational pamphlet and assigned to a waiting list. The knitting program (-8-week duration) has two components: bi-weekly 20-minute group knitting sessions and 20-minute home daily knitting on the 5 remaining weekdays. Measures included knitting adherence (implementation outcomes) as well as stiffness, pain, functional status, hand physical activity level, patient's global impression of change, health-related quality of life, self-efficacy, and grip strength (clinical outcomes measured throughout the 8-week program and 4 weeks after the intervention).
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Quebec
-
Ottawa, Quebec, Canada
- University of Ottawa
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Meet the clinical and radiographic criteria of definite HOA set out by the American College of Rheumatology (ACR) and have experienced pain symptoms for at least 3 months;
- Be a woman aged between 50 and 85 years; 3) have moderate to severe morning stiffness (defined as a score ≥ 4 on a 10 cm visual analogue scale at the time of study entry;
- Display X-ray evidence of joint space narrowing of the hands;
- Have no previous experience with knitting or have not knitted in the last 6 months;
- Be available for sessions at the senior's club twice weekly;
- Be able to understand written and verbal English instructions.
Exclusion Criteria:
- Suffered from other orthopedic or rheumatologic diseases (e.g., inflammatory arthritis), or showed evidence of chondrocalcinosis;
- Had a history of finger joint surgery;
- Suffered from an acute disease, such as uncontrolled diabetes mellitus, untreated hypertension, neurological deficits (motor or sensory), cognitive deficit or mental health conditions;
- Were taking OA medication that was expected to change during the study period;
- Were receiving current rehabilitation treatments or any other pain-related treatment besides medication for OA;
- Had received a corticosteroid injection in a finger joint within the last 6 months;
- Planned to move outside the region within 6 months.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: experimental
Educational pamphlet and knitting program
|
Pamphlet and knitting program (-8-week duration).
The knitting program has two components: bi-weekly 20-minute group knitting sessions and 20-minute home daily knitting on the 5 remaining weekdays.
|
|
Other: control
Educational pamphlet and assigned to a waiting list
|
Receive only the pamphlet, not the knitting program.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Stiffness
Time Frame: daily for 12 weeks
|
0-100 visual analog scale where 0 = no stiffness, 100 = worst imaginable stiffness
|
daily for 12 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Dropout rates
Time Frame: week 8
|
Assessed through a in-house questionnaire
|
week 8
|
|
Adherence to the knitting program
Time Frame: Baseline, week 4, week 8, and week 12
|
It was estimated using the logbook and the seniors club attendance sheet, whereby we divided the number of knitting sessions completed (at the club and at home) by the number of knitting sessions prescribed (56 sessions)
|
Baseline, week 4, week 8, and week 12
|
|
pain level
Time Frame: Multiple times daily for 12 weeks
|
0-100 visual analog scale where 0 = no pain, 100 = worst imaginable pain
|
Multiple times daily for 12 weeks
|
|
Functional status
Time Frame: Baseline, week 4, week 8, and week 12
|
Was assessed using the Australian/Canadian Osteoarthritis Hand Index (AUSCAN).
It consists in a 15-item scale, with items grouped into three subsections: A) pain intensity, B) stiffness severity, and C) hand functional status/difficulty in activities of daily living.
For each item, scores range from 0 (no symptoms) to 4 (severe symptoms)
|
Baseline, week 4, week 8, and week 12
|
|
Hand physical activity
Time Frame: Baseline, week 4, week 8, and week 12
|
was measured using an adapted version of the 7-Day Physical Activity Readiness (PAR).
It is in the form of a calendar in which participants record the duration (minutes per day) and frequency (days per week) of physical activity.
|
Baseline, week 4, week 8, and week 12
|
|
Patient's global impression of change
Time Frame: Baseline, week 4, week 8, and week 12
|
It was assessed by asking patients if, following the knitting program, their condition was: 1) very much improved; 2) much improved; 3) minimally improved; 4) no change; 5) minimally worse; 6) much worse; 7) very much worse
|
Baseline, week 4, week 8, and week 12
|
|
Health-related Quality of life (QoL)
Time Frame: Baseline, week 4, week 8, and week 12
|
It was evaluated using the EuroQoL Index (EQ-5D-5L), which covers mobility, self-care, daily activities, Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems.
|
Baseline, week 4, week 8, and week 12
|
|
Self-efficacy
Time Frame: Baseline, week 4, week 8, and week 12
|
It was assessed using The Stanford Arthritis Self-Efficacy Scale, consisting in statements which patients rate on a ten-point scale ranging from 1 (very uncertain) to 10 (very certain).
|
Baseline, week 4, week 8, and week 12
|
|
Bilateral hand grip strength
Time Frame: Baseline, week 4, week 8, and week 12
|
It was measured using a portable JAMAR Hydraulic Hand Dynamometer in the standardized sitting position
|
Baseline, week 4, week 8, and week 12
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- H02-16-12
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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