Effects of a Self-Management Exercise Program for Individuals with Knee Osteoarthritis in Kanchanaburi Province
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Abstract
This research aimed to: 1) systematically review the components and effectiveness of self-management exercise programs for individuals with knee osteoarthritis; 2) develop a self-management exercise program for individuals with knee osteoarthritis in Kanchanaburi Province; and 3) evaluate the appropriateness of the developed program. A Mixed Methods Research design was employed, conducted in three phases: Phase 1 involved a systematic review and meta-analysis from five databases (PubMed, Scopus, Web of Science, Cochrane Library, and CINAHL) covering 2019-2025; Phase 2 involved program development through a Focus Group Discussion with five stakeholders; and Phase 3 involved evaluation of the program's appropriateness by five experts using the Connoisseurship Evaluation framework.
The findings were as follows. First, following PRISMA guidelines, 63 studies met the inclusion criteria for the systematic review, of which 11 were included in the meta-analysis. The meta-analytic findings indicated that self-management exercise programs were highly effective in reducing pain (Pooled SMD = -0.921, 95% CI: -1.038 to -0.804, p < 0.001) and effective in improving self-efficacy (Pooled SMD = 0.786, 95% CI: 0.644 to 0.928, p < 0.001). Both effect sizes were classified as moderate to large according to Cohen's criteria. Effective programs were characterized by four essential components: health education, individualized exercise, goal setting, and pain management. Second, through synthesis of the systematic review findings and focus group data, a 12-week self-management exercise program consisting of six modules was developed, grounded in Self-Regulation Theory (Kanfer & Gaelick-Buys, 1991) and Self-Efficacy Theory (Bandura, 1997). Content validity was confirmed with a Content Validity Index (CVI) of 0.94. Third, expert evaluation indicated that the program was rated at the highest level of appropriateness (Mean = 4.59, SD = 0.49).
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