Factors influencing pain response following GLA:D® patient education and supervised exercise in males and females with hip osteoarthritis

OBJECTIVE: Understand factors associated with pain intensity responder status following non-surgical hip OA intervention, according to sex.

METHODS: Data were from individuals with hip OA participating in the Danish GLA:D® 8-week education and exercise program. Factors captured at program entry: age, education, mental well-being, comorbidities, body mass index, symptoms in hip, knee and low back, and program-specific factors: education sessions, former participant lecture, supervised exercise sessions. Pain intensity was captured at baseline and 3-months (post-program) on a 0-100 visual analogue scale. Response was defined as pain intensity improvement ≥30% from baseline to post-program. Logistic regression was used and conducted separately in males and females.

RESULTS: The sample included 791 males and 2,253 females. Females had a mean baseline pain of 47.2/100 (95% CL: 46.4, 48.1) and males 41.7 (95% CL: 40.3, 43.1). By post-program, the proportion of pain responders was 50.4% among females and 45.8% among males (difference p=0.025). Among females, program-specific factors (attending former participant lecture and more supervised exercise sessions) were positively associated with pain response, as were better mental well-being and fewer comorbidities, while symptoms in other joints/site were associated with a decreased likelihood of response. Among males, program-specific factors were not associated with response, while better mental well-being and fewer comorbidities were associated with being a responder.

CONCLUSIONS: Findings suggest that the influence of some factors on pain response differ for males and females, and point to a potential need for targeted approaches for males and females who may require different key messages/approaches from healthcare providers.