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It is believed that clinical management of osteoarthritis should address muscle weakness to improve physical function and prevent disability and frailty.This sub-study investigated the effects of supervised progressive resistance training (RT), supervised Nordic Walking (NW), and unsupervised home-based exercise (HBE) on muscle and functional performance; and associations between these exercise-induced changes in persons with hip osteoarthritis.Forty-two patients with hip osteoarthritis were recruited from a larger RCT (NCT01387867). All the groups (RT,Per protocol analyses (one-way ANOVA and Bonferroni test) showed significant between-group differences for improvements in QCSA in the most symptomatic leg favoring RT versus NW (2.3 cmResistance training appeared effective for improving muscle mass, but less effective for improving muscle strength, power, and functional performance. Only exercise-induced changes in muscle strength and power of the least symptomatic leg, not the most symptomatic leg, were related to changes in functional performance.

BACKGROUND AND PURPOSE: Some uncertainty persists regarding the reproducibility of the recommended core set of performance-based tests, as well as common muscle function tests, when applied in individuals with knee osteoarthritis (KOA). The purpose of this study was to investigate the intrarater reliability and agreement of the recommended core set of performance-based tests and common muscle function tests in KOA.METHODS: Participants (N=40) with radiographic and/or symptomatic KOA were evaluated twice with a 3-day interval between test sessions using the following tests: Leg extensor (LE) maximal muscle power measured in a Nottingham Power Rig; knee extensor (KE) peak isometric strength measured with a handheld dynamometer; 40-m walk test; 30-second chair-stand test; and 9-step stair climb test. Reliability was assessed using a 2-way, mixed-effects, single-measures model (3,1), absolute agreement-type intraclass correlation coefficient (ICC). Agreement was assessed using 95% limits of agreement (LOA) and LOA relative to the mean score from test and retest (LOA-%).RESULTS: Reliability for all tests was very high (ICC ≥ 0.97). LOA (LOA-%) was ±32.3 watt (W) (±22%) for LE power; ±22.7 N·m (±24%) for KE strength; ±0.2 m/s (±10%) for 40-m walk test; ±2.4 repetitions (±14%) for 30-second chair-stand test; and ±2 second (±20%) for stair climb test. A potential participant learning effect was found for all 3 performance-based tests, indicated by the significantly better scores at retest.DISCUSSION: The very high reliability found for the performance-based tests supports findings from previous studies and confirms discriminate reliability of these tests on a group level. Also, very high reliability estimates were demonstrated for both muscle function tests. This study also provided estimates of agreement for both performance-based and muscle function tests, which are important to consider when using these tests on an individual level in clinical practice.CONCLUSION: When using these tests to monitor changes over time in the clinic, depending on the test, improvements of less than 10% to 24% could be a result of measurement error alone and therefore may not be considered an actual improvement after treatment.

To investigate COPD patients' experience on the mastering of their illness during participation in a long-term interprofessional and cross-sectoral telerehabilitation programme called C☺PD-Life≫.A phenomenological-hermeneutic study design with combined participant observations and individual interviews formed a continuous data generation among fifteen patients while they participated in the programme. Data underwent a three-levelled interpretation inspired by the theory of the French philosopher Paul Ricoeur.During participation in C☺PD-Life≫ patients experienced an improvement in how to master their living with COPD. They felt invigorated by an interprofessional rehabilitation team to raise how to deal with physical, mental, social and relational challenges. Programme participation was experienced as surprisingly easy by the patients.The telerehabilitation solution C☺PD-Life≫ provides benefits for COPD patients who report improved illness-mastering, attendance and outcome of rehabilitation, as well as enhanced physical and social activity. As an assistive technology intervention, C☺PD-Life≫ appears to be a valuable addition to existing rehabilitation programmes. However, more knowledge is required to further understand the full-range capacity and impact of tele-based pulmonary rehabilitation.Implications for RehabilitationNew models of rehabilitation to patients with Chronic Obstructive Pulmonary Disease (COPD) is imperative for the development of more suitable health care support to these patients. C☺PD-Life≫ is a twenty-six-long telerehabilitation intervention program for COPD patients, delivered by an interdisciplinary team collaborating between hospital and the municipality health care service.This paper aims to explore COPD patients' experiences on the mastering of their illness while participating in C☺PD-Life≫.Patients report improved illness-mastering, attendance, and outcome of rehabilitation, as well as enhanced physical and social activity by participating in the program.As an assistive technology solution, C☺PD-Life≫ is shown to provide the potential to expand equally assessable support in improving independence, functioning, and well-being to COPD patients.