One area where I am constantly challenged is the management of degenerative disease in the setting of a workplace injury. In my practice, that is commonly osteoarthritis of the knee, and rotator cuff tears in the shoulder.
Increasingly it is recognised that osteoarthritic conditions respond best to a specific, holistic intervention that includes education, weight loss, and exercise. An inflamed arthritic joint cannot be “ loaded up” in the same way that we rehab an athlete. I’ve been talking to Mike Devine at SportsMed Subiaco about a globally successful osteoarthritis program they are now running – GLA:D.
Mike, what is GLA:D?
Mike: GLA:D, or Good Life with Arthritis: Denmark, is an education and exercise program developed by researchers in Denmark for people with hip or knee osteoarthritis symptoms.
This education and exercise program reflects the latest evidence in osteoarthritis (OA) research. It also includes feedback from people with OA and trainers, on what works in the real world to help patients manage OA symptoms.
What does it involve?
- The program starts with two free education sessions which teach you about OA, how the GLA:D exercises improve joint stability, and how to retain this improved joint stability outside the program.
- An initial appointment explaining the program, assessing your current functional ability, and providing you with an individualised exercise program.
- Group neuromuscular training sessions are held twice a week for six weeks to improve muscle control of the joint which leads to reduction in symptoms and improved quality of life.
Who is suitable for this program?
OA is the most common lifestyle disease in individuals 65 years of age and older, but can also affect individuals as young as 30 years of age. GLA:D is a program for all individuals who experience any hip or knee osteoarthritis symptoms, regardless of severity.
Some patients may not be suitable if –
- They have other reasons for their hip and/or knee pain, including: tumour, inflammatory joint disease, result of hip fracture, soft tissue or connective tissue problems.
- They have other symptoms that are more pronounced than the osteoarthritis problems (for example chronic generalized pain or fibromyalgia).
What is the background to the program?
Current national and international clinical guidelines recommend patient education, exercise and weight loss as a first-line treatment for osteoarthritis.
Research from the GLA:D program in Denmark found symptom progression reduces by 32%.
Other outcomes include less pain, reduced use of joint-related pain killers, and fewer people on sick leave. GLA:D participants also reported high levels of satisfaction with the program and increased levels of physical activity 12 months after starting the program.
This program is unique in that the education and exercises provided can be applied to everyday activities. By strengthening and correcting daily movement patterns, participants will train their bodies to move properly, prevent symptom progression and reduce pain.
ConclusionDavid: Thanks Mike, I completely agree that osteoarthritic conditions need a very specific intervention plan. And including a discussion on comorbidities like obesity means that the patient is much more likely to return to work, and reduce the risk of future flare ups.
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Dr David Colvin consults at:
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Dr David Colvin operates at:
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Subiaco WA 6008