Development of a UK online 24-h dietary assessment tool:Myfood24

Abstract: Assessment of diet in large epidemiological studies can be costly and time consuming. An automated dietary assessment system could potentially reduce researcher burden by automatically coding food records. myfood24 (Measure Your Food on One Day) an online 24-hour dietary assessment tool (with the flexibility to be used for multiple 24hour-dietary recalls or as a food diary), has been developed for use in the UK population. Development of myfood24 was a multi-stage process. Focus groups conducted with three age groups, adolescents (11-18 yrs) (n = 28), adults (19-64 yrs) (n= 24) and older adults (≥65 years) (n= 5) informed the development of the tool, and usability testing was conducted with beta (adolescents n= 14, adults n= 8, older adults n= 1) and live (adolescents n= 70, adults n= 20, older adults n= 4) versions. Median system usability scale (SUS) scores (measured on a scale of 0-100) in adolescents and adults were marginal for the beta version (adolescents median SUS =66, interquartile range (IQR) =20; adults median SUS=68, IQR=40) and good for the live version (adolescents median SUS= 73, IQR =22; adults median SUS= 80, IQR=25). myfood24 is the first online 24 hour dietary recall tool for use with different age groups in the UK. Usability testing indicates that myfood24 is suitable for use in UK adolescents and adults

GPs' attitudes, beliefs and behaviours regarding exercise for chronic knee pain: a questionnaire survey

OBJECTIVES: The aim of this study was to investigate general practitioners' (GPs) attitudes, beliefs and behaviours regarding the use of exercise for patients with chronic knee pain (CKP) attributable to osteoarthritis. SETTING: Primary care GPs in the UK. PARTICIPANTS: 5000 GPs, randomly selected from Binley's database, were mailed a cross-sectional questionnaire survey. OUTCOME MEASURES: GPs' attitudes and beliefs were investigated using attitude statements, and reported behaviours were identified using vignette-based questions. GPs were invited to report barriers experienced when initiating exercise with patients with CKP RESULTS: 835 (17%) GPs responded. Overall, GPs were positive about general exercise for CKP. 729 (87%) reported using exercise, of which, 538 (74%) reported that they would use both general and local (lower limb) exercises. However, only 92 (11% of all responding) GPs reported initiating exercise in ways aligning with best-evidence recommendations. 815 (98%) GPs reported barriers in using exercise for patients with CKP, most commonly, insufficient time in consultations (n=419; 51%) and insufficient expertise (n=337; 41%). CONCLUSIONS: While GPs' attitudes and beliefs regarding exercise for CKP were generally positive, initiation of exercise was often poorly aligned with current recommendations, and barriers and uncertainties were reported. GPs' use of exercise may be improved by addressing the key barriers of time and expertise, by developing a pragmatic approach that supports GPs to initiate individualised exercise, and/or by other professionals taking on this role

Best evidence osteoarthritis care: What are the recommendations and what Is needed to improve practice?

This article provides an overview of osteoarthritis (OA) management recommendations and strategies to improve clinical practice concordance with clinical guidelines. In many countries, the primary point of care for a person with OA is typically general practitioners and physiotherapists. Optimal primary care focuses on core OA treatments, namely education for self-management and lifestyle interventions encompassing increased physical activity, therapeutic exercise, and weight loss (if indicated). Quality indicators are used in clinical practice and research to determine the quality of care and in some settings, are used as knowledge translation tools to address existing evidence-to-practice gaps

GPs' attitudes, beliefs and behaviours regarding exercise for chronic knee pain: a questionnaire survey

OBJECTIVES:The aim of this study was to investigate general practitioners' (GPs) attitudes, beliefs and behaviours regarding the use of exercise for patients with chronic knee pain (CKP) attributable to osteoarthritis.SETTING: Primary care GPs in the UK.PARTICIPANTS: 5000 GPs, randomly selected from Binley's database, were mailed a cross-sectional questionnaire survey.OUTCOME MEASURES: GPs' attitudes and beliefs were investigated using attitude statements, and reported behaviours were identified using vignette-based questions. GPs were invited to report barriers experienced when initiating exercise with patients with CKP RESULTS: 835 (17%) GPs responded. Overall, GPs were positive about general exercise for CKP. 729 (87%) reported using exercise, of which, 538 (74%) reported that they would use both general and local (lower limb) exercises. However, only 92 (11% of all responding) GPs reported initiating exercise in ways aligning with best-evidence recommendations. 815 (98%) GPs reported barriers in using exercise for patients with CKP, most commonly, insufficient time in consultations (n=419; 51%) and insufficient expertise (n=337; 41%). CONCLUSIONS: While GPs' attitudes and beliefs regarding exercise for CKP were generally positive, initiation of exercise was often poorly aligned with current recommendations, and barriers and uncertainties were reported. GPs' use of exercise may be improved by addressing the key barriers of time and expertise, by developing a pragmatic approach that supports GPs to initiate individualised exercise, and/or by other professionals taking on this role

Usability and preliminary effectiveness of an app-based physical activity and education program for people with hip or knee osteoarthritis: a pilot randomized controlled trial

Background: Hip and knee osteoarthritis (OA) are highly prevalent worldwide. The guidelines recommend physical activity and education as the core treatments for osteoarthritis. Digital health has the potential to engage people in physical activity and disease management. Therefore, we conducted a pilot trial to assess the usability and preliminary effectiveness of an app-based physical activity and education program (Join2Move) compared to usual care for people with hip and/or knee OA in Germany. Methods: A randomized controlled pilot study was conducted. Individuals with diagnosed or self-reported knee and hip OA were included. Allocation to the intervention or control group was randomized. The intervention group received the Join2Move program. The Join2Move program was previously developed as a website and evaluated in the Netherlands. For the current study, the program was translated and adapted to the German context and adjusted from a website to an app. The control group received usual care. The primary outcomes were usability and preliminary effectiveness (pain and physical functioning). Measurements were taken at baseline and at twelve weeks. The data analysis was performed using SPSS (IBM SPSS Statistics 29.0). Results: Sixty participants, with a mean age of 61.9 (SD ± 7.2) years, were allocated to the intervention (n = 32) or the control group (n = 28) and included in the analysis. The majority of participants had knee OA (68%), and 12% had hip and knee OA. The dropout rate was n = 11 (18%). No adverse events were reported. Usability was rated as acceptable (mean System Usability Scale = 71.3/100) with a wide range (32.5 to 100). Statistically significant between-group differences were found only for pain (mean difference 8.52 (95% CI 1.01 to 16.04), p = 0.027). Conclusions: Join2Move demonstrated acceptable usability. The preliminary results of the pilot trial indicate the potential of a stand-alone app for the treatment of patients with hip or knee OA. However, the acceptable usability of Join2Move limits its recommendation for everyone. There appears to be room for improvement in app usability and in identifying patients for whom the app is suitable and the right time to use a stand-alone app. Trial registration: German Clinical Trials Register DRKS00027164

Efectos a corto plazo en el dolor, la función y las cualidades musculares de la implementación de la punción seca a un programa de ejercicio terapéutico online en pacientes con artrosis de cadera leve o moderada

Introducción: La artrosis de cadera es una patología crónica degenerativa que afecta a la articulación de la cadera y a las estructuras periarticulares. Su abordaje terapéutico es limitado, existiendo evidencia sobre el efecto beneficioso de la punción seca y el ejercicio terapéutico para el control sintomático, pero se carecen de datos sobre su uso combinado.Objetivos: El objetivo principal de este estudio es analizar la efectividad de la implementación de la punción seca a un programa de ejercicio terapéutico online en pacientes con artrosis de cadera.Metodología: Se ha realizado un estudio observacional prospectivo tipo serie de casos con un tamaño muestral de tres pacientes afectos de artrosis de cadera leve o moderada. Tras efectuar una valoración inicial completa (historia clínica, dolor, capacidad funcional, rango de movimiento, fuerza muscular y cuestionarios específicos), se ejecutó un programa de ejercicio terapéutico online, basado en ejercicios de fortalecimiento muscular, estiramientos y automovilizaciones articulares, durante cuatro semanas y una sesión de punción seca semanal. Al concluir la intervención, se realizó una valoración final y se compararon los resultados con los datos iniciales.Resultados y Discusión: En los tres casos se observaron diferencias tras la intervención, que resultaron clínicamente significativas en las variables dolor, rango de movimiento, fuerza y capacidad funcionalConclusiones: La intervención propuesta ha logrado una mejoría en el dolor, el rango de movimiento, la sensación de rigidez, la fuerza muscular y la capacidad funcional en los tres pacientes participantes en el estudio.<br /