University Of Tasmania
153847 - effect of combined exercise.pdf (728.83 kB)

Effect of combined exercise training and behaviour change counselling versus usual care on physical activity in patients awaiting hip and knee arthroplasty: A randomised controlled trial

Download (728.83 kB)
journal contribution
posted on 2023-05-21, 14:17 authored by Andrew WilliamsAndrew Williams, Jane O'BrienJane O'Brien, Mulford, J, Mathew, R, Thapa, DK, Hamilton, K, Cheney, M, Matthew SchmidtMatthew Schmidt, Wu, S, Marie-Louise BirdMarie-Louise Bird

Objective: This study aimed to determine if a novel intervention that combined individualised exercise training with behaviour change counselling based on Health Action Process Approach (HAPA) constructs could elicit long-term increase in physical activity (PA) and reduce comorbidity development among people requiring hip or knee arthroplasty.

Method: A pre-registered two arm, parallel group, randomised controlled trial comparing the effect of a 12-week individualised exercise program combined with behavioural counselling delivered by accredited exercise physiologists, versus usual care to Osteoarthritis (OA) patients on public surgery waitlists. Participants were followed up at 6 months after baseline (pre-surgery) and again at 6 months post-surgery. Within and between group differences in post-surgery PA (as measured by ActivPal accelerometer), pain, function, quality of life, HAPA-based behavioural and psychological constructs, and health risk factors were analysed.

Results: 63 participants (34 Female; Mean age ​= ​66.4 ​± ​7.2 ​yrs) consented to participate in this study. At 6 months post baseline and 6 months post-surgery there were significant improvements in PA, pain, function, and quality of life, however there were no significant differences in the between group responses. Significant between group changes were observed in several psychological constructs related to volition at 6 months post baseline; however, these had disappeared by 6 months post-surgery.

Conclusions: An exercise program and HAPA guided counselling intervention can improve psychological constructs related to exercise behaviour; however, these did not result in significant between group changes in PA at the timepoints measured. Further research with larger sample size is required.


Clifford Craig Foundation


Publication title

Osteoarthritis and Cartilage Open





Article number









School of Health Sciences


Elsevier Ltd

Place of publication

United Kingdom

Rights statement

© 2022. The Authors. Published by Elsevier Ltd on behalf of Osteoarthritis Research Society International (OARSI). This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License ( which permits non-commercial use, reproduction, and distribution of the work without further permission provided the original work is attributed.

Repository Status

  • Open

Socio-economic Objectives

Allied health therapies (excl. mental health services)

Usage metrics

    University Of Tasmania