Activity Pacing Education for People with Osteoarthritis: A Systematic Review of the Current Evidence-base
Toby O. Smith, Leigh Davies, Jill Jepson, Sherif Hosny and Caroline B. Hing
Affiliation: Queen's Building, School of Allied Health Professions, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK.
Activity pacing is commonly provided by occupational therapists, physiotherapists and other healthcare professionals.
Pacing education encourages people to intersperse activity with rest periods in order to alter inefficient activity
patterns. The purpose of this study was to examine the literature assessing the clinical outcomes of activity pacing
with people diagnosed with osteoarthritis (OA).
The electronic databases AMED, CINAHL, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials,
Biomed Central, unpublished literature databases and trial registries, were searched to 1st June 2013. All studies assessing
the clinical outcomes of activity pacing or modifying/change programmes for people with OA were included. The
methodological quality of the studies was assessed using the PEDro critical appraisal tool.
A total of 164 citations were reviewed, identifying three papers, reporting clinical outcomes from one trial in total.
Thirty-two participants were reviewed with hip and knee OA. The evidence-base, whilst based on small, underpowered
cohorts, provided moderate rigour based on the PEDro appraisal findings. The results indicated that activity pacing can
reduce joint stiffness, fatigue and potentially pain in those with hip and knee OA. This appears more effective tailored
to an individual.
Whilst the current evidence suggests that activity pacing may have value for people with hip and knee OA, there is a
major paucity of literature assessing the efficacy or effectiveness of activity pacing for people with OA. Further study
is required to assess the clinical outcomes of activity pacing for those with OA affecting different joints, within a variety
of different populations.
Keywords: Hip, knee, osteoarthritis, occupational therapy, activity pacing, behaviour modification.
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