Search

Background Compensational movement patterns in hip osteoarthritis (HOA) are associated with hip dysfunction. Basic Body Awareness Therapy (BBAT) promotes functional movement quality and might, accordingly, be beneficial in HOA. Objective To examine the outcomes of BBAT compared to standard care in people with HOA after first receiving patient education (PE). Study Design A prospective, assessor-blinded, and block-randomized controlled trial. Methods Community-living adults with HOA participating in PE were randomly allocated to an intervention group receiving BBAT in groups (12 sessions offered once a week), or a comparison group. Data at baseline (pretest) and at 6 months (posttest) were analyzed. Primary outcomes were pain during walking assessed by the Numeric Rating Scale (NRS) and function by the Hip Osteoarthritis Outcome Score, subscale ADL (HOOS A). Secondary outcomes addressed physical capacity, movement quality, and self-reported aspects of function and health. Results At pretest, there were no significant differences in demographic and test data between the intervention (n = 51) and the comparison (n = 50) group. Forty-one intervention and 45 comparison participants completed the posttest. At posttest, no significant differences in change between groups were found on NRS (p = 0.694, effect size (ES) = 0.02) or HOOS A (p = 0.783, ES = 0.07). Among secondary outcomes, movement quality improved significantly more (p < 0.001, ES = 0.84) in the intervention group. Compliance with BBAT varied substantially. Per-protocol analysis showed changes in favor of the intervention group for self-efficacy (p = 0.049, ES = 0.36), health (p = 0.037, ES = 0.44), and function (p = 0.029, ES = 0.53) when only intervention participants who completed at least 10 sessions of BBAT were included. Conclusions BBAT was not found to be a more effective treatment modality than self-initiated standard care to reduce pain during walking and improve daily functioning in people with HOA. Movement quality was significantly more improved in participants receiving BBAT, and improvement in other health aspects was associated with sufficient therapy compliance. publishedVersion

Background: Patients' access to movement experiences is implemented in the evaluation tool Body Awareness Rating Scale - Movement Quality and Experience, with its two intertwined parts: 1) the physiotherapist's observations of movement quality; and 2) the patient's descriptions of immediate movement experiences.Objective: To study movement experiences and reflections described by patients diagnosed with hip osteoarthritis when guided to explore simple daily-life movements in this particular evaluation context.Design: An explorative qualitative study with open-ended questions following each of the 12 movements integrated into the evaluation.Methods: 35 participants diagnosed with hip osteoarthritis were included; 28 women and 7 men, aged 23-78 years. Their descriptions were audiotaped, transcribed verbatim and analyzed in accordance with qualitative content analysis.Results: The patients described experiences of a dynamic adaptation of movement strategies based on sensations from the moving body. Two interrelated categories of movement awareness were identified: 1) Experienced movement challenges, including three sub-categories; a) Lack of contact, b) Movement changed by symptoms, and c) Compensational movement habits, and 2) Movement components promoting well-being, including three sub-categories; a) Integrating balance, breathing and awareness into movement, b) Small, simple, soft and safe movements, and c) A taste of own movement resources for daily life.Conclusions: The Body Awareness Rating Scale - Movement Quality and Experience provides a platform for patients to become aware of and describe their movement habits and resources in own words, intertwined with the physiotherapist movement observations. Derived descriptions reflect a patient perspective to be implemented in therapy.

Osteoarthritis (OA) is associated with pain, dysfunction and reduced quality of life. Patient education (PE) followed by 12 weekly sessions of Basic Body Awareness Therapy (BBAT) was offered to patients with hip OA, aiming to strengthen their ability to move and act functionally in daily life.To explore how patients described their experiences and outcome from participating in PE and BBAT.Individual, semi-structured interviews with five patients, aged 52-78 years, were performed after PE and BBAT at four and ten months. Interview data were analyzed by systematic text condensation.Three main themes emerged. "Becoming motivated and involved" reflected experiences of encouragement and support from information given and communication with group members. In "Movement awareness learning" patients described becoming aware of and improving functional movement, alleviating symptoms and increasing daily functioning. "Movement and disease in a long-term perspective" reflected patientś experience of increased self-awareness and taking better care of themselves at 10 months after baseline. Practicing basic movement principles, they felt empowered to handle daily life challenges in more functional and energy-economical ways.PE followed by BBAT in groups may be beneficial to patients with hip OA, and provide lasting benefits regarding daily life function. Implications for Rehabilitation Insight into disease process and relationship to functional movement gained through patient education may empower patients with hip osteoarthritis in management of daily life Movement awareness and exploration of movement quality using principles from Basic Body Awareness Therapy was found to support patients in finding resources for functional movement, implemented in daily actions Movement strategies characterized by adjustment rather than force was experienced by the patients to support their general functioning, despite of prevailing hip pain Implementing group therapeutic factors (Yalom) in physiotherapy was found to strengthen patients' motivation and belief in functional improvement.

International guidelines recommend exercise and patient education (PE) in hip osteoarthritis. However, we need more in-depth evidence regarding the effect of different exercise modalities. The aim of this study was to examine short- and long-term outcomes of PE and Basic Body Awareness Therapy (BBAT). Seven patients (five men, two women) with moderate to severe osteoarthritis were recruited. Pain, function and quality of life were assessed at baseline and after 4 and 10 months, pain during walking being the main outcome. PE, aiming for patients’ empowerment through information and counselling, was given in a 2 h group setting. BBAT, focusing on promoting movement quality and awareness in a variety of daily movements, was given weekly in groups over 12 weeks. Five patients participated in PE and BBAT, two in PE only. After 4 months all reported improvement. Less pain during walking was found in four patients, and after 10 months in three patients (one PE, two PE and BBAT, two missing). One patient ...

Background:Patients with hip osteoarthritis tend to develop stereotype and energy demanding movement strategies with potential negative effects on disease progression and daily life functioning. A multi-perspective view on movement quality is applied in the physiotherapy modality Basic Body Awareness Therapy (BBAT), with its movement awareness learning pedagogy. BBAT has been found beneficial for functional movement quality, symptoms, and psychological aspects of health in patients with various long-lasting conditions.Objectives:To investigate the short-term (6 months) effects of BBAT, added to Patient Education (PE) compared with PE only in patients with hip osteoarthritis.Methods:A block-randomized controlled trial with 6 months follow-up was conducted. Patients were allocated to 3.5 hours of PE plus 12 weekly sessions of BBAT, each lasting 90 minutes (intervention group), or to PE only (comparison group). Primary outcomes: Numeric Rating Scale (NRS) for pain during walking and Hip Osteoarthritis Outcome Score, subscale Activities of Daily Life (HOOS A). Secondary outcomes included physical capacity tests: Chair test, Stairs test, six-minutes walking test (6MWT), movement quality evaluation: Body Awareness Rating Scale – Movement Quality and Experience (BARS-MQE), and self-reported measures: Activity level (UCLA), function (HOOS subscales P, S, SP, QL and Harris Hip Score (HHS), self-efficacy (Arthritis Self-efficacy Scale, ASES), and health (EuroQol, EQ-5D-5L).Patient Global Impression of Change (PGIC) on pain and function was registered at 6 months.ANCOVA of change was used in intention-to-treat and per protocol analysis.Results:101 patients were included, average age 63 years, 80% female. There was no difference in change between the groups on the primary outcomes at 6 months. However, movement quality (BARS-MQE) improved more (pConclusion:Patients with hip osteoarthritis were not found by the primary outcome measures to improve more by BBAT added to PE than by PE alone. Movement quality improved, however, significantly more in the intervention group. With sufficient compliance to BBAT, significant more improvement in additional health indicators was demonstrated.References:[1] Egloff C, Hugle T, Valderrabano V. Biomechanics and pathomechanisms of osteoarthritis. Swiss Med Wkly. 2012;142:w13583.[2] Smith TO, Purdy R, Lister S, Salter C, Fleetcroft R, Conaghan P. Living with osteoarthritis:Systematic review and meta-ethnography. Scand J Rheumatol. 2014;43(6):441-452.[3] Skjaerven LH, Kristoffersen K, Gard G. An eye for movement quality: a phenomenological study of movement quality reflecting a group of physiotherapists’ understanding of the phenomenon. Physiother Theory Pract. 2008;24(1):13-27.Acknowledgments:The authors thank the funding institution; The Norwegian Fund for Post-graduate training in Physiotherapy.Disclosure of Interests:None declared

Movement quality assessed by the Body Awareness Rating Scale (BARS) is used as an indicator of health and self-efficacy in patients with long-lasting musculoskeletal and mental health problems. The...