Search

Introduction and Aims: Patients awaiting hip or knee joint arthroplasty, often wait for 12 months or more and during this time have low levels of physical activity. Evidence suggests individualised exercise prescription before surgery can be highly beneficial for reducing the development of co-morbidities, however there are challenges in facilitating participation in exercise for these individuals. Method: A randomised control trial examining benefits of exercise and behaviour change for patients awaiting hip and knee arthroplasty. As study recruitment rates were lower than expected, those who declined to participate were invited to provide reasons for their decision. An analysis of these reasons has been conducted. Results: 485 patients were approached to participate in the study, of these 62 (13%) agreed and 423 declined (87%). Of the 423 patients who declined, 355 were asked their reason for not enrolling. Reasons for not participating fitted into 2 major themes; 36% (n=128) identified difficulties travelling to the location as a reason for declining and 15% (n= 53) didn’t want to participate in exercise. The remaining patients; 19% (n=67) provided a variety of reasons and 30% (n= 107) didn’t respond to repeated efforts to contact. Conclusion: Travel has been major factor affecting recruitment for the study examining exercise combined with behaviour change for people waiting for hip or knee arthroplasty. Potential participants were widely distributed across the state and the requirement to travel to only one location for the intervention negatively impacted recruitment. Investigations into alternative methods of delivery for future studies involving dispersed populations is therefore warranted.

Introduction Controlled trials support the efficacy of exercise as a treatment modality for chronic conditions, yet effectiveness of real-world Exercise Physiology services is yet to be determined. This study will investigate the efficacy and cost-effectiveness of services provided by Accredited Exercise Physiologists (AEPs) for clients with type 2 diabetes (T2D) in clinical practice. Methods and analysis A non-randomised, opportunistic control, longitudinal design trial will be conducted at ten Exercise Physiology Clinics. Participants will be individuals with T2D attending one of the Exercise Physiology Clinics for routine AEP services (exercise prescription and counselling) (intervention) or individuals with T2D not receiving AEP services (usual care) (control). The experimental period will be 6 months with measurements performed at baseline and at 6 months. Primary outcome measures will be glycosylated haemoglobin (HbA1c), resting brachial blood pressure (BP), body mass index, waist circumference, 6 min walk test, grip strength, 30 s sit to stand, Medical Outcomes Short-Form 36-Item Health Survey and Active Australia Questionnaire. Secondary outcomes will be medication usage, out-of-pocket expenses, incidental, billable and non-billable health professional encounters and work missed through ill health. Healthcare utilisation will be measured for 12 months prior to, during and 12 months after trial participation using linked data from Medicare Benefits Schedule and Pharmaceutical Benefits Scheme data. Ethics and dissemination The study is a multicentre trial comprising: University of Tasmania, University of New South Wales Lifestyle Clinic, University of Canberra, Baker Heart and Diabetes Institute (covered under the ethics approval of University of Tasmania Health and Medical Ethics Committee H0015266), Deakin University (Approval number: 2016-187), Australian Catholic University (2016-304R), Queensland University of Technology (1600000049), University of South