Activity Pacing Education for People with Osteoarthritis: A Systematic Review of the Current Evidence-base

Activity pacing is commonly provided by occupational therapists, physiotherapists and other healthcare professionals. Pacing education encourages people to intersperse activity with rest periods in order to alter inefficient activity patterns. The purpose of this study was to examine the literature assessing the clinical outcomes of activity pacing with people diagnosed with osteoarthritis (OA). The electronic databases AMED, CINAHL, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Biomed Central, unpublished literature databases and trial registries, were searched to 1st June 2013. All studies assessing the clinical outcomes of activity pacing or modifying/change programmes for people with OA were included. The methodological quality of the studies was assessed using the PEDro critical appraisal tool. A total of 164 citations were reviewed, identifying three papers, reporting clinical outcomes from one trial in total. Thirty-two participants were reviewed with hip and knee OA. The evidence-base, whilst based on small, underpowered cohorts, provided moderate rigour based on the PEDro appraisal findings. The results indicated that activity pacing can reduce joint stiffness, fatigue and potentially pain in those with hip and knee OA. This appears more effective tailored to an individual. Whilst the current evidence suggests that activity pacing may have value for people with hip and knee OA, there is a major paucity of literature assessing the efficacy or effectiveness of activity pacing for people with OA. Further study is required to assess the clinical outcomes of activity pacing for those with OA affecting different joints, within a variety of different populations.