Facilitating Activity and Self-management for people with Arthritic knee, hip or lower back pain (FASA): A cluster randomised controlled trial

N. Walsh, L. Jones, S. Phillips, R Thomas, L. Odondi, S. Palmer, F. Cramp, J. Pollock, M. Hurley

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)
33 Downloads (Pure)


Background: Chronic musculoskeletal pain including osteoarthritis (OA) can significantly limit the functional independence of individuals. The spine and hip and knee are predominantly affected; management guidelines for each recommend exercise and education to support self-management. Objectives: This study investigated the effectiveness of a generic exercise and self-management intervention for people over-50 with hip/knee OA and/or lower back pain compared to continued GP management. Design: Single blind, cluster randomised controlled trial. Method: Participants who had previously consulted with hip/knee OA and/or chronic lower back pain were recruited from 45 GP practices in SW England. Practices were randomly allocated to receive continued GP care (control) or continued GP care and a 6-week group exercise and self-management intervention facilitated by a physiotherapist and located in a community-based physiotherapy department. The primary outcome measure was the Dysfunction Index of the Short Musculoskeletal Functional Assessment (DI-SMFA) measured at six month post-rehabilitation. Results: 349 participants were recruited and allocated to the intervention (n = 170) or control (n = 179) arms; the attrition rate was 13% at the 6 month primary end-point. One minor adverse event in the intervention group that required no medical input was reported. Intervention arm participants reported better function at 6 months compared with continued GP management alone (−3.01 difference in DI-SMFA [95%CI -5.25, −0.76], p = 0.01). Conclusions: A generic exercise and self-management intervention resulted in statistically significant changes in function after six-months compared with GP management alone, but clinical significance of these findings is less clear. This may be an effective way of managing group interventions for lower limb OA and chronic lower back pain.

Original languageEnglish
Article number102271
JournalMusculoskeletal Science and Practice
Early online date10 Oct 2020
Publication statusPublished - Dec 2020
Externally publishedYes

Bibliographical note

NOTICE: this is the author’s version of a work that was accepted for publication in Musculoskeletal Science and Practice. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Musculoskeletal Science and Practice, 50, (2020)
DOI: 10.1016/j.msksp.2020.102271

© 2020, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation


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