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The Effect of Theory-driven Physiotherapy on Physical Activity in Knee OA.
Sponsor: Mark van Loo
Summary
Knee osteoarthritis (OA) is a leading cause of pain, disability, and reduced physical functioning worldwide. Although physiotherapy and physical activity are recommended as first-line treatments, many individuals with knee OA do not achieve or maintain recommended levels of physical activity. As a result, the benefits of evidence-based physiotherapy are often not fully realized. To improve physical activity participation, effective behaviour change interventions are needed. Theory-informed interventions have the potential to enhance physiotherapy outcomes by targeting the psychological determinants that influence physical activity behaviour. One well-established framework is the Theory of Planned Behaviour (TPB), which proposes that behaviour is primarily influenced by behavioural intention, attitude, subjective norms, and perceived behavioural control. To translate these determinants into intervention content, behaviour change techniques (BCTs) can be systematically selected using tools such as the Behaviour Change Intervention Ontology (BCIO), Mechanisms of Action Ontology (MoAO), and Theory and Techniques Tool (TaTT). This approach may improve the effectiveness and sustainability of behaviour change interventions. The present study therefore aims to evaluate the potential of a TPB-based behaviour change intervention as an addition to guideline-recommended physiotherapy for individuals with knee OA. The primary objective is to determine whether this theory-driven intervention can improve physical activity levels and reduce sedentary behaviour. A secondary objective is to explore the behavioural mechanisms through which these changes occur. The study will employ a randomized, concurrent, multiple-baseline single-case experimental design (SCED). Participants with knee OA will receive a six-week physiotherapy intervention consisting of usual guideline-based care supplemented with a TPB-based behaviour change component. Physical activity and sedentary behaviour will be continuously assessed using ActiGraph accelerometers. In addition, behavioural determinants, pain, and functional limitations will be repeatedly measured to evaluate potential mechanisms of action and clinical effects. Findings from this study may contribute to the development of more effective, theory-informed physiotherapy interventions aimed at promoting sustainable physical activity behaviour in people with knee OA.
Official title: What is the Effect of Theory-driven Physiotherapy on Physical Activity in People With Knee Osteoarthritis: A Multiple Baseline Single-case Experimental Design Study.
Key Details
Gender
All
Age Range
45 Years - 70 Years
Study Type
INTERVENTIONAL
Enrollment
20
Start Date
2026-10-30
Completion Date
2028-01-01
Last Updated
2026-10-28
Healthy Volunteers
No
Conditions
Interventions
EXPLOR-3
The behaviour change component will be developed based on the TPB. Selection of corresponding MoAs and BCTs will be guided by the BCIO, the MoA Ontology, and the TaTT. Within the TPB framework, three MoAs are known to predict intention and actual behavior. Accordingly, the intervention applies a stepwise, phased approach when implementing TPB within a physiotherapy context aimed at increasing physical activity (≥150 minutes of moderate physical activity per week). The intervention first targets individuals' attitudes toward the behavior (treatment phase 1, duration 1-2 weeks), followed by enhancement of perceived behavioral control (treatment phase 2, duration 2-3 weeks), and subsequently aims to strengthen behavioral intention (treatment phase 3, duration 2 weeks). For each phase, specific BCTs will be selected to align with the corresponding MoAs (based on link within TaTT) and will be tailored to individual patient needs, as assessed by the physical therapist.
Locations (1)
Rotterdam University of Applied Science
Rotterdam, Netherlands