PATIENT PERSPECTIVES ON THEIR CREAKY KNEES AND THE ROLE OF EXERCISE IN KNEE HEALTH

Osteoarthritis (OA) is highly prevalent worldwide, carrying a significant disease burden. Evidence-based guidelines recommend exercise as a key first-line treatment modality and has been found to aid in prevention of developing OA. However, people still appear to be unsure about undertaking exercise to improve their knee health and this may occur before they have been diagnosed with OA. Knee crepitus may be cause people to negatively modify their exercise behaviours due to concerns of joint degeneration, though this is yet to be fully explored. Thus, the overarching objective of this study is to identify attitudes and beliefs of individuals with knee crepitus. More specifically, we aim to investigate if people have concerns about their crepitus and if they respond to these concerns through behavioural modification and to identify their beliefs regarding the role of exercise in knee health.

Adult participants who had knee crepitus, with or without OA, took part in either an online individual semi-structured interview or focus groups to explore their beliefs regarding their crepitus and what effect this may have had on their exercise behaviours. Content analysis from interview transcripts was conducted using an inductive approach (NVivo software).

Twenty-four participants volunteered to be interviewed (mean age 49 years, range 21–69 years, 67% female). Three main themes emerged regarding attitudes and behaviours 1) crepitus, 2) exercise and 3) health professional engagement. A key concern was what crepitus meant and whether it would lead to development of OA. Participants said that crepitus varied in type. Most participants had not ceased exercise but had modified their movement due to crepitus and associated symptoms, with some having increased intentional strength training to try alleviating it. For those already with OA or other symptoms, crepitus was of less concern than symptoms such as pain. Participants agreed that more understanding about the processes causing crepitus and what exercise was safe for knee health would be beneficial.

Crepitus does not appear to be a major concern for people who experience it. However, it is a factor that influences exercise behaviours, as is pain. If health professionals could address these concerns by providing greater education and targeted exercise, people with crepitus might be more confident in exercising for the benefit of their joints and overall health.