12 results found
Manning VL, Kaambwa B, Ratcliffe J, et al., 2015, Economic evaluation of a brief education, self-management and upper limb exercise training in people with rheumatoid arthritis (EXTRA) programme: a trial-based analysis., Rheumatology (Oxford), Vol: 54, Pages: 302-309
OBJECTIVE: The aim of this study was to conduct a cost-utility analysis of the Education, Self-management and Upper Limb Exercise Training in People with RA (EXTRA) programme compared with usual care. METHODS: A within-trial incremental cost-utility analysis was conducted with 108 participants randomized to either the EXTRA programme (n = 52) or usual care (n = 56). A health care perspective was assumed for the primary analysis with a 36 week follow-up. Resource use information was collected on interventions, medication, primary and secondary care contacts, private health care and social care costs. Quality-adjusted life years (QALYs) were calculated from the EuroQol five-dimension three-level (EQ-5D-3L) questionnaire responses at baseline, 12 and 36 weeks. RESULTS: Compared with usual care, total QALYs gained were higher in the EXTRA programme, leading to an increase of 0.0296 QALYs. The mean National Health Service (NHS) costs per participant were slightly higher in the EXTRA programme (by £82), resulting in an incremental cost-effectiveness ratio of £2770 per additional QALY gained. Thus the EXTRA programme was cost effective from an NHS perspective when assessed against the threshold of £20 000-£30 000/QALY gained. Overall, costs were lower in the EXTRA programme compared with usual care, suggesting it was the dominant treatment option from a societal perspective. At a willingness-to-pay of £20 000/QALY gained, there was a 65% probability that the EXTRA programme was the most cost-effective option. These results were robust to sensitivity analyses accounting for missing data, changing the cost perspective and removing cost outliers. CONCLUSION: The physiotherapist-led EXTRA programme represents a cost-effective use of resources compared with usual care and leads to lower health care costs and work absence. TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number Register; http://www.controlled-trials.com/isrctn/
Manning VL, Hurley MV, Scott DL, et al., 2014, Education, self-management, and upper extremity exercise training in people with rheumatoid arthritis: a randomized controlled trial., Arthritis Care Res (Hoboken), Vol: 66, Pages: 217-227
OBJECTIVE: To evaluate the effectiveness of a brief supervised education, self-management, and global upper extremity exercise training program, supplementing a home exercise regimen, for people with rheumatoid arthritis (RA; the Education, Self-Management, and Upper Extremity Exercise Training in People with Rheumatoid Arthritis [EXTRA] program). METHODS: Adults with RA of ≤5 years' duration were randomized to receive either usual care or the EXTRA program comprising 4 (1-hour) group education, self-management, and global upper extremity exercise training sessions supplementing the first 2 weeks of a 12-week individualized, functional home exercise regimen in addition to usual care. Outcome measures were assessed at baseline, 12 weeks (primary end point), and 36 weeks and included the Disabilities of the Arm, Shoulder, and Hand questionnaire (primary outcome measure), the Grip Ability Test, handgrip strength (N), the Arthritis Self-Efficacy Scale (pain, function, and symptoms subscales), and the 28-joint Disease Activity Score. RESULTS: One hundred eight participants (26 men, mean ± SD age 55 ± 15 years, mean ± SD disease duration 20 ± 19 months) were randomized to receive either usual care (n = 56) or the EXTRA program (n = 52). At 12 weeks, there was a significant between-group difference in the mean change in disability (-6.8 [95% confidence interval (95% CI) -12.6, -1.0]; P = 0.022), function (-3.0 [95% CI -5.0, -0.5]; P = 0.011), nondominant handgrip strength (31.3N [95% CI 9.8, 52.8]; P = 0.009), self-efficacy (10.5 [95% CI 1.6, 19.5]; P = 0.021 for pain and 9.3 [95% CI 0.5, 18.2]; P = 0.039 for symptoms), and disease activity (-0.7 [95% CI -1.4, 0.0]; P = 0.047), all favoring the EXTRA program. CONCLUSION: The EXTRA program improves upper extremity disability, function, handgrip strength, and self-efficacy in people with RA, with no adverse effects on disease activity.
Wiik AV, Manning V, Strachan RK, et al., 2013, Unicompartmental knee arthroplasty enables near normal gait at higher speeds, unlike total knee arthroplasty, Journal of Arthroplasty, Vol: 28, Pages: 176-178, ISSN: 0883-5403
Top walking speed (TWS) was used to compare UKA with TKA. Two groups of 23 patients, well matched for age, gender, height and weight and radiological severity were recruited based on high functional scores, more than twelve months post UKA or TKA. These were compared with 14 preop patients and 14 normal controls. Their gait was measured at increasing speeds on a treadmill instrumented with force plates. Both arthroplasty groups were significantly faster than the preop OA group. TKA patients walked substantially faster than any previously reported series of knee arthroplasties. UKA patients walked 10% faster than TKA, although not as fast as the normal controls. Stride length was 5% greater and stance time 7% shorter following UKA — both much closer to normal than TKA. Unlike TKA, UKA enables a near normal gait one year after surgery.
Manning VL, Hurley MV, Scott DL, et al., 2013, "I DEFINITELY WOULD RECOMMEND IT ... I THINK IT'S BEEN QUITE AMAZING REALLY": EXPERIENCES OF AN UPPER LIMB EDUCATION, SELF-MANAGEMENT, AND EXERCISE TRAINING PROGRAMME (THE EXTRA PROGRAMME) AMONG PEOPLE WITH EARLY RHEUMATOID ARTHRITIS, BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND, European League Against Rheumatism, Publisher: BMJ PUBLISHING GROUP, Pages: 354-354, ISSN: 0003-4967
Manning VL, Hurley M, Scott DL, et al., 2013, A BRIEF EXERCISE AND SELF-MANAGEMENT PROGRAMME IMPROVES UPPER LIMB DISABILITY IN PEOPLE WITH EARLY RHEUMATOID ARTHRITIS, GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND, Annual Meeting of the British-Society-for-Rheumatology and British-Health-Professionals-in-Rheumatology, Publisher: OXFORD UNIV PRESS, Pages: 147-148
Manning VL, Hurley M, Scott DL, et al., 2013, 'I THINK HAVING A PROGRAMME LIKE THAT FOR PEOPLE WHO HAVE GOT RHEUMATOID ARTHRITIS IS WELL WORTH DOING': EXPERIENCES OF AN UPPER LIMB EDUCATION, SELF-MANAGEMENT AND EXERCISE PROGRAMME AMONG PEOPLE WITH EARLY RHEUMATOID ARTHRITIS, GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND, Annual Meeting of the British-Society-for-Rheumatology and British-Health-Professionals-in-Rheumatology, Publisher: OXFORD UNIV PRESS, Pages: 102-102
Aqil A, Drabu R, Bergmann J, et al., 2013, The Gait Of Patients With One Resurfacing And One Replacement Hip: A Single Blinded Controlled Study, International Orthopaedics
Manning VL, Hurley MV, Scott DL, et al., 2012, Are patients meeting the updated physical activity guidelines? Physical activity participation, recommendation, and preferences among inner-city adults with rheumatic diseases., J Clin Rheumatol, Vol: 18, Pages: 399-404
BACKGROUND: Physical activity (PA) improves the health of people with rheumatic diseases. Revised guidelines (published in the United States in 2008 and in the United Kingdom in 2011) recommend that adults complete 150 or more minutes of moderate-intensity PA or 75 or more minutes of vigorous-intensity PA (or equivalent) in bouts of 10 or minutes per week, yet whether people with rheumatic diseases meet these guidelines is unknown. OBJECTIVES: This study evaluates the PA levels of adults with rheumatic diseases attending an inner-city hospital against the updated PA guidelines. It assesses respondents' PA preferences and the proportion who report ever receiving PA advice from a healthcare professional (HCP). METHODS: Five hundred and eight patients (46% response rate) attending the general rheumatology clinics of an inner-city UK hospital completed the self-report International Physical Activity Questionnaire and 3 additional questions: "Has a doctor or other HCP ever suggested PA or exercise to help your arthritis or joint symptoms?" "Would you like help from your doctor or health service to become more physically active?" and "Which physical activities do you enjoy?" RESULTS: Overall, 61% of respondents met the updated PA guidelines, and 39% did not meet the guidelines. Forty-three percent of respondents reported ever receiving PA advice from an HCP, and 50% reported that they would "like help" to become more physically active. Walking was the most preferred PA (65%). CONCLUSIONS: Almost two-thirds of our respondents met the updated PA guidelines; however, many were entirely inactive. Recommending regular PA should be integral to rheumatic disease management, and walking offers a potentially accessible, inexpensive, and acceptable PA intervention.
Bearne L, Manning VL, Scott DL, et al., 2012, A Brief Exercise and Self Management Programme Improves Upper Limb Disability in People with Early Rheumatoid Arthritis, Annual Scientific Meeting of the American-College-of-Rheumatology (ACR) and Association-of-Rheumatology-Health-Professionals (ARHP), Pages: S1027-S1027
Manning VL, Hurley MV, Scott DL, et al., 2012, Are Patients Meeting the Updated Physical Activity Guidelines? Physical Activity Participation, Recommendation, and Preferences Among Adults with Rheumatic Diseases, 111 RIVER ST, HOBOKEN 07030-5774, NJ USA, Annual Scientific Meeting of the American-College-of-Rheumatology (ACR) and Association-of-Rheumatology-Health-Professionals (ARHP), Publisher: WILEY-BLACKWELL, Pages: S869-S869
Manning VL, Hurley M, Scott DL, et al., 2011, PHYSICAL INACTIVITY IN ADULTS WITH RHEUMATIC CONDITIONS, GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND, Annual Meeting of the British-Society-for-Rheumatology 2011, Publisher: OXFORD UNIV PRESS, Pages: S34-S34
Marcora SM, Staiano W, Manning V, 2009, Mental fatigue impairs physical performance in humans, JOURNAL OF APPLIED PHYSIOLOGY, Vol: 106, Pages: 857-864, ISSN: 8750-7587
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