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How do UK physiotherapists address weight loss among individuals with hip osteoarthritis? A mixed-methods study

Holden, Melanie Ann; Waterfield, Jackie; Whittle, Rebecca; Bennell, Kim; Quicke, Jonathan George; Chesterton, Linda; Mallen, Christian

Authors

Jackie Waterfield

Rebecca Whittle

Kim Bennell

Jonathan George Quicke

Linda Chesterton



Abstract

BACKGROUND
Weight loss is recommended as a core treatment for individuals with hip osteoarthritis who are overweight or obese. Physiotherapists play an important role in managing patients with hip osteoarthritis, but little is known about how they address weight. We aimed to explore how UK-based physiotherapists currently address weight loss among individuals with hip OA.

METHODS
We carried out a mixed-methods study. A cross-sectional questionnaire was mailed to 3,126 UK-based musculoskeletal physiotherapists. Self-reported approaches to addressing weight loss among individuals with hip osteoarthritis were explored using a case vignette and associated clinical management questions. Semi-structured telephone interviews (n = 21) were completed with a purposeful sample of physiotherapists who returned the questionnaire and provided consent for further contact. Interview data were analysed thematically.

RESULTS
There was a 53% response rate to the questionnaires (n = 1,646), and 1,148 responders were eligible for analyses (based on having treated an individual with hip OA in the last 6 months). Eight-five per cent of physiotherapists reported that they would address the vignette patient's weight, usually via advice (70%). Interviews identified that advice often focused on the importance of weight loss, with some physiotherapists offering basic advice on how to achieve weight loss. Multiple factors influenced their approach, including confidence, perceived remit and patient receptiveness.

CONCLUSIONS
UK physiotherapists commonly address weight loss among patients with hip osteoarthritis, by offering advice relating to the importance of weight loss. However, provision of more specific guidance on how to achieve weight loss is variable. With additional training, physiotherapists could play an important role in supporting weight loss among patients with hip OA, thus potentially optimizing treatment outcomes.

Journal Article Type Article
Acceptance Date Nov 28, 2018
Publication Date 2019-03
Publicly Available Date Mar 29, 2024
Journal Musculoskeletal Care
Print ISSN 1478-2189
Publisher Wiley
Volume 17
Issue 1
Pages 133-144
DOI https://doi.org/10.1002/msc.1383
Keywords hip, mixed methods, osteoarthritis, physiotherapy, weight
Publisher URL http://doi.org/10.1002/msc.1383