Browsing by Author "Hurley, M. V."
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Item Metadata only Clinical effectiveness of a rehabilitation program integrating exercise, self-management and active coping strategies for chronic knee pain: A cluster randomised trial.(Wiley, 2007) Hurley, M. V.; Walsh, N. E.; Mitchell, H.; Pimm, J.; Patel, A.; Williamson, E.; Jones, R. H.; Dieppe, P. A.; Reeves, B. C.Item Metadata only Economic evaluation of a rehabilitation program integrating exercise, self-management and active coping strategies for chronic knee pain for chronic knee pain.(Wiley, 2007) Hurley, M. V.; Walsh, N. E.; Mitchell, H.; Pimm, T. J.; Williamson, E.; Jones, R. H.; Reeves, B. C.; Dieppe, P. A.; Patel, A.Item Metadata only In osteoarthritis, the psychosocial benefits of exercise are as important as physiological improvements.(American College of Sports Medicine, 2003) Hurley, M. V.; Mitchell, H.; Walsh, N. E.Item Metadata only Integrated exercise and self-management programmes in osteoarthritis of the hip and knee: a systematic review of effectiveness(Maney Publishing, 2006) Walsh, N. E.; Mitchell, H.; Reeves, B. C.; Hurley, M. V.Item Embargo Long-term outcomes and costs of an integrated rehabilitation program for chronic knee pain: A pragmatic, cluster, randomized, controlled trial.(Wiley, 2012-02) Hurley, M. V.; Walsh, N. E.; Mitchell, H.; Nicholas, J.; Patel, A.Objective. Chronic joint pain is a major cause of pain and disability. Exercise and self-management have short-term benefits, but few studies follow participants for more than 6 months. We investigated the long-term (up to 30 months) clinical and cost effectiveness of a rehabilitation program combining self-management and exercise: Enabling Self- Management and Coping of Arthritic Knee Pain Through Exercise (ESCAPE-knee pain). Methods. In this pragmatic, cluster randomized, controlled trial, 418 people with chronic knee pain (recruited from 54 primary care surgeries) were randomized to usual care (pragmatic control) or the ESCAPE-knee pain program. The primary outcome was physical function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] function), with a clinically meaningful improvement in physical function defined as a >15% change from baseline. Secondary outcomes included pain, psychosocial and physiologic variables, costs, and cost effectiveness. Results. Compared to usual care, ESCAPE-knee pain participants had large initial improvements in function (mean difference in WOMAC function 5.5; 95% confidence interval [95% CI] 7.8, 3.2). These improvements declined over time, but 30 months after completing the program, ESCAPE-knee pain participants still had better physical function (difference in WOMAC function 2.8; 95% CI 5.3, 0.2); lower community-based health care costs (£ 47; 95% CI £ 94, £ 7), medication costs (£ 16; 95% CI £ 29, £ 3), and total health and social care costs (£ 1,118; 95% CI £ 2,566, £ 221); and a high probability (80–100%) of being cost effective. Conclusion. Clinical and cost benefits of ESCAPE-knee pain were still evident 30 months after completing the program. ESCAPE-knee pain is a more effective and efficient model of care that could substantially improve the health, well-being, and independence of many people, while reducing health care costs.Item Metadata only Management of chronic knee pain: A survey of patient preferences and treatment received(2008) Mitchell, H.; Hurley, M. V.