{
  "abstract": "Objectives To investigate the association of diabetes, hypertension and overweight/obesity with physical activity (PA), self-efficacy for pain and self-efficacy for other symptoms before and after a 6- week exercise and education intervention for knee and hip osteoarthritis (OA), and to assess outcome disparities based on metabolic health.Methods Register-based cohort study using the Swedish Osteoarthritis and Diabetes cohort. We used Body Mass Index, medical records and medication dispensation to define overweight/obesity, hypertension and diabetes at baseline (exposures). PA was self-reported (weekly minutes), and self-efficacy was measured using the ‘Arthritis Self-Efficacy Scale’ (ASES) (score 10–100) (outcomes). We used linear mixed-effect models to estimate associations between exposures and outcomes, adjusted for confounders.Results We included 80 893 individuals with knee or hip OA. Those with metabolic conditions consistently showed lower PA and self-efficacy, with baseline disparities persisting after the intervention, particularly when all three conditions coexisted (PA difference: baseline 107 min [95% CI: 97; 118], 3-month 97 [86; 108], 12-month 109 [95; 123]; ASES-pain difference: baseline 5.6 [3.9; 7.3], 3-month 5.9 [4.1; 7.7], 12-month 8.2 [6.1; 10.4]; ASES-other symptoms difference: baseline 6.1 [4.6; 7.7], 3-month 6.4 [4.8; 8.0], 12-month 8.2 [6.3; 10.1]).Conclusions Metabolic conditions were associated with lower PA and self-efficacy, with differences increasing with the number of co-existing conditions. The baseline disparities associated with metabolic conditions persisted after the intervention, with both groups showing improvement at 3 months but reverting to baseline by 12 months. This suggests that current guideline-based interventions for OA may not reduce long-term disparities related to metabolic conditions.",
  "authors": [
    {
      "affiliations": [
        "Department of Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden",
        "Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy"
      ],
      "name": "Filippo Recenti"
    },
    {
      "affiliations": [
        "Department of Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden",
        "School of Health and Society, Centre for Human Movement and Rehabilitation, University of Salford, Salford, UK"
      ],
      "name": "Simone Battista"
    },
    {
      "affiliations": [
        "Faculty of Medicine, Department of Clinical Sciences Lund, Orthopedics, Lund University, Lund, Sweden"
      ],
      "name": "Stefan Lohmander"
    },
    {
      "affiliations": [
        "Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"
      ],
      "name": "Johanna Vinblad"
    },
    {
      "affiliations": [
        "Department of Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden"
      ],
      "name": "Ali Kiadaliri"
    },
    {
      "affiliations": [
        "Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden",
        "Department of Orthopaedics in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden"
      ],
      "name": "Allan Abbott"
    },
    {
      "affiliations": [
        "Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden",
        "Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden"
      ],
      "name": "Ola Rolfson"
    },
    {
      "affiliations": [
        "Department of Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden"
      ],
      "name": "Martin Englund"
    },
    {
      "affiliations": [
        "Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy"
      ],
      "name": "Marco Testa"
    },
    {
      "affiliations": [
        "Department of Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden"
      ],
      "name": "Andrea Dell’Isola"
    }
  ],
  "title": "Association between metabolic conditions, physical activity and self-efficacy before and after a first-line exercise and education intervention for osteoarthritis: a longitudinal register study using the SOAD cohort",
  "uid": "169d4a03-78e3-57ac-a94a-0e58b6e73b82"
}