GLA:D – The Osteoarthritis Program Everyone is Talking About
What is GLA:D?
“GLA:D” is a program specifically designed for people experiencing symptoms of knee or hip osteoarthritis (OA). Developed by researchers in Denmark, the program incorporates exercises and education to conservatively improve symptoms and improve function and quality of life for people experiencing hip and knee joint degeneration.
What is Osteoarthritis (OA)?
OA is an umbrella term describing reduced cartilage in synovial joints, which can lead to pain and reduced function. Highly prevalent and causing significant disability globally, OA reduces quality of life, function and independence (Hurley et al., 2018). One in 11 Australians (2.1 million people) were estimated to experience OA in 2014-2015 ("Osteoarthritis snapshot, What is osteoarthritis?", 2019).
What are the Symptoms of OA?
Symptoms commonly present as an intermittent deep ache or pain and stiffness with joint use, with symptoms easing with rest. As the disease progresses symptoms can increase and become more consistent, including symptoms at rest and at night (Hurley et al., 2018).
Due to OA being a slowly developing chronic disease, early intervention and prevention strategies can prove highly beneficial (Ageberg & Roos, 2015). Risk factors for OA include traumatic joint injury, increased body weight, family history, repetitive kneeling or squatting and repetitive heavy lifting ("Osteoarthritis snapshot, What is osteoarthritis?", 2019).
In the management of OA, clinical guidelines recommend patient education, exercise and weight loss as the first line of treatment (Guideline for the management of knee and hip arthritis, 2018).
What does the Evidence Tell Us?
Systematic reviews and clinical practice guidelines strongly recommend exercise and education programs in order to improve symptoms of OA (Guideline for the management of knee and hip arthritis, 2018). The main symptoms of pain and function can be improved, as well as other important elements such as self-efficacy, mental health, and quality of life (Hurley et al., 2018). The reductions in pain have been shown to be comparable to those of analgesic and non-steroidal anti-inflammatory drugs (Fransen et al., 2015).
Along with these specific benefits, the positive effects of increasing weekly physical activity levels are strongly represented in high quality literature, such as reduced rates of various chronic diseases, other comorbidities and overall health (Guideline for the management of knee and hip arthritis. 2018).
Randomised controlled trials are consistent in reporting the positive effects of conservative interventions, which include exercise and education. These have shown significant improvements in OA symptoms in people suffering mild to moderate OA, and have delayed joint replacement surgery for at least 2 years in people with moderate to severe OA (Skou et al., 2018).
What does a GLA:D Program look like?
GLA:D utilises education and exercise to improve symptoms, function and quality of life for people experiencing hip and/or knee OA, delivered by a GLA:D certified practitioner. The program begins with an initial one-on-one assessment, followed by six weeks of supervised group exercise sessions, occurring twice per week. Two group education sessions occur within the six weeks, and a follow-up assessment concludes the program.
People who are eligible to take part in the program include those experiencing knee or hip joint problems and/or a diagnosis of knee or hip OA.
The GLA:D program at Donvale Rehabilitation Hospital is run by accredited GLA:D clinicians to improve pain, function and quality of life for people suffering from OA.
Further information can be downloaded from Ramsay Health Plus webpage.
Phone: 9841 1204
Ageberg, E., & Roos, E. (2015). Neuromuscular Exercise as Treatment of Degenerative Knee Disease. Exercise And Sport Sciences Reviews, 43(1), 14-22. doi: 10.1249/jes.0000000000000030
Fransen, M., McConnell, S., Harmer, A., Van der Esch, M., Simic, M., & Bennell, K. (2015). Exercise for osteoarthritis of the knee. Cochrane Database Of Systematic Reviews. doi: 10.1002/14651858.cd004376.pub3
Guideline for the management of knee and hip arthritis. (2018). The Royal Australian Collage of General Practitioners (2nd ed.). Retrieved on July 2nd, 2019 via the Australian Govenrment NHMRC website www.racgp.org.au/FSDEDEV/media/documents/Clinical%20Resources/Guidelines/Joint%20replacement/Guideline-for-the-management-of-knee-and-hip-OA-2nd-edition.pdf
Hurley, M., Dickson, K., Hallett, R., Grant, R., Hauari, H., & Walsh, N. et al. (2018). Exercise interventions and patient beliefs for people with hip, knee or hip and knee osteoarthritis: a mixed methods review. Cochrane Database Of Systematic Reviews. doi: 10.1002/14651858.cd010842.pub2
Osteoarthritis snapshot, What is osteoarthritis?. (2019). Retrieved from www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis/contents/what-is-osteoarthritis
Skou, S., Roos, E., Laursen, M., Rathleff, M., Arendt-Nielsen, L., Rasmussen, S., & Simonsen, O. (2018). Total knee replacement and non-surgical treatment of knee osteoarthritis: 2-year outcome from two parallel randomized controlled trials. Osteoarthritis And Cartilage, 26(9), 1170-1180. doi: 10.1016/j.joca.2018.04.014