The Effects of a Knitting Program on Osteoarthritis Symptoms in Elderly Women

Not Applicable

Completed

• Conditions: Osteoarthritis
• Interventions: Other: Education (pamphlet); Other: Knitting and education (pamphlet)

• Registration Number: NCT05975229
• Lead Sponsor: Université de Sherbrooke

Brief Summary

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).

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 Timeline

• Study Start: 2017-08-01
• Primary Completion: 2017-12-20
• Study Completion: 2017-12-20
• Study First Submitted: 2023-07-24
• Status Verified: 2023-08
• Study First Submitted QC: 2023-08-01
• Last Update Submitted: 2023-08-01
• Study First Posted: 2023-08-03
• Last Update Posted: 2023-08-03

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 37

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.

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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.

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
control	Education (pamphlet)	Educational pamphlet and assigned to a waiting list
experimental	Knitting and education (pamphlet)	Educational pamphlet and knitting program

Primary Outcome Measures

Name	Time	Method
Stiffness	daily for 12 weeks	0-100 visual analog scale where 0 = no stiffness, 100 = worst imaginable stiffness

Secondary Outcome Measures

Name	Time	Method
Dropout rates	week 8	Assessed through a in-house questionnaire
Adherence to the knitting program	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)
pain level	Multiple times daily for 12 weeks	0-100 visual analog scale where 0 = no pain, 100 = worst imaginable pain
Health-related Quality of life (QoL)	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.
Self-efficacy	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).
Functional status	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)
Patient's global impression of change	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
Bilateral hand grip strength	Baseline, week 4, week 8, and week 12	It was measured using a portable JAMAR Hydraulic Hand Dynamometer in the standardized sitting position
Hand physical activity	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.

Trial Locations

Locations (1)

University of Ottawa; 🇨🇦 Ottawa, Quebec, Canada