An evaluation of physical fitness and physical activity to support therapeutic exercise prescription for individuals with knee osteoarthritis in Saudi Arabia: a mixed-methods study

Subahi, Moayad 2021. An evaluation of physical fitness and physical activity to support therapeutic exercise prescription for individuals with knee osteoarthritis in Saudi Arabia: a mixed-methods study. PhD Thesis, Cardiff University. Item availability restricted.

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Abstract

Background: knee osteoarthritis is a highly prevalent condition recognised as a whole-body disease and a leading cause of chronic disabilities. Therapeutic exercise and promotion of physical activity are core treatments for knee osteoarthritis (OA) that could improve their physical fitness that would provide the physical foundations for enabling physical activity. However, there is a lack of comprehensive assessment of physical fitness components and physical activity levels of individuals with knee OA within the same group in Saudi Arabia. The current guidelines lack details on exercise prescription such as frequency, intensity, type, and time, which may not effectively guide the physiotherapists when developing a treatment plan for individuals with knee osteoarthritis. Moreover, healthcare providers play an essential role in promoting physical activity in the community for people with knee OA. However, in Saudi Arabia, limited studies explored the current healthcare management of knee osteoarthritis, their perspective on the barriers and facilitators to physical activity, their decision-making process, and evidence-based practice and guidelines implementation. Study aims: The aim of this study was to evaluate physical fitness and physical activity to support therapeutic exercise prescription for individuals with knee osteoarthritis in Saudi Arabia. This study had two objectives. The first objective was to measure PF and PA difference between individuals with knee OA and healthy controls. The second objective was to explore the stakeholder perspectives on the opportunities and barriers to physical activity for individuals with knee OA and how it impacts healthcare delivery. Methods: An emergent sequential, explanatory mixed-methods study design was used. The study was divided into two phases; phase one was a quantitative study that used a case-control design to assess physical fitness components, physical activity level and barriers and facilitators to physical activity in individuals with knee osteoarthritis and healthy controls. Phase two was a qualitative study using semi-structured interviews included a purposive sample from different stakeholder categories: healthy people, individuals with knee osteoarthritis, physiotherapists, physicians, personal trainer and schoolteacher. Both phases were integrated at the results and discussion levels to synthesise the findings and answer the research questions that could help to explain the results of phase one. Findings and Discussion: The findings of the first phase showed that individuals with knee osteoarthritis have lower physical fitness components compared to healthy controls (P > 0.05). No significant difference was found in body composition component of physical fitness or physical activity levels (P < 0.05), as both groups were overweight/obese and physically inactive. There was a number of barriers to physical activity and a suggestion that low physical activity could be a cultural problem. The thematic analysis of phase two showed several barriers to physical activity, with limited efforts and advice to promote physical activity in the Saudi population. Moreover, the current healthcare service is providing a negative experience for individuals with knee OA with several limitations in the individuals’ journey for seeking healthcare. Conclusion: The comprehensive assessment of physical fitness and physical activity suggest that physical fitness components such as aerobic capacity, muscle fitness, balance and flexibility are affected, and they could be included in the treatment plan for individuals with knee OA. In addition, the identified barriers to physical activity could indicate the need for national strategies to include behaviour frameworks to support a theoretical approach in development of intervention to promote physical activity in the Saudi population.

Item Type:	Thesis (PhD)
Date Type:	Completion
Status:	Unpublished
Schools:	Healthcare Sciences
Date of First Compliant Deposit:	30 September 2021
Last Modified:	03 Aug 2022 01:39
URI:	https://orca.cardiff.ac.uk/id/eprint/144560

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