Why do some people with osteoarthritis and obesity awaiting hip or knee arthroplasty achieve successful weight management and physical activity levels while others don’t?

Miss Natalie Pavlovic1,2, Dr Furkan Genel3,4, Miss Manxin Gao5, Mrs Danella Hackett2, Dr Robert Boland2,6, Professor Ian Harris1,4,7, Professor Victoria Flood8,9, Dr Bernadette Brady6,7,10, A/Professor Justine Naylor1,4

1South Western Sydney Clinical School, University of New South Wales, , , 2Fairfield Hospital, South Western Sydney Local Health District, Prairiewood, 2176, Australia, 3St George and Sutherland Clinical School, University of New South Wales, , , 4Whitlam Orthopaedic Research Centre, Ingham Institute, South Western Sydney Local Health District, , , 5University of New South Wales, , Australia, 6Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, 2006, Australia, 7Liverpool Hospital, South Western Sydney Local Health District, Liverpool, 2170, Australia, 8Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, 2006, Australia, 9Westmead Hospital, Western Sydney Local Health District, Westmead, 2145, Australia, 10Western Sydney University, School of Science and Health, Campbelltown, 2560, Australia

Aim: To explore factors affecting weight management, dietary habits and physical activity (PA) participation in people with obesity awaiting total knee or hip arthroplasty within an Osteoarthritis Chronic Care Program (OACCP).

Design: Nested qualitative study within a multi-centre, quasi-experimental pilot study comparing usual care weight management to dietitian-led weight management.

Methods: A purposive sample of adults with end-stage osteoarthritis and a body mass index ≥ 30 waitlisted for primary total knee or hip arthroplasty was investigated. In-depth semi-structured interviews were conducted 6 months post-recruitment. Perceived barriers and enablers to increasing PA, weight management and changing dietary habits were investigated using a piloted topic guide. Inductive thematic analysis aligning with a constructivist-interpretivist epistemology was used.

Results: Twenty-five interviews were conducted (18 women and 7 men aged 44-80 years). Qualitative findings identified several themes underpinning successful weight management including, readiness to change, adaptability, navigating healthcare, social context, dietary habits and PA. Dietary habits were shaped by a combination of themes relating to a person’s sociocultural context, diet-specific strategies, knowledge about healthy eating and food preference while the themes of adaptability, perceptions about PA, and sociocultural context framed participants’ uptake of PA while waiting for arthroplasty.

Conclusion: Understanding a person’s ability to adapt, their perceptions and their sociocultural context may help guide weight management and physical activity advice and prescription given by clinician’s involved in their care.


Biography:

Natalie Pavlovic is currently a PhD student at the University of New South Wales. Her thesis is focused on investigating the relationship between osteoarthritis and obesity on postoperative complications in patients undergoing total hip or knee arthroplasty procedures.

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