Improving Physical Activity Using an Online Monitoring Tool: a New Model of Care for Knee Osteoarthritis
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Knee Osteoarthritis
- Sponsor
- University of British Columbia
- Enrollment
- 61
- Locations
- 1
- Primary Endpoint
- Time Spent in Moderate-to-Vigorous Physical Activity (MVPA)
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
Physical activity is an essential first-line treatment for patients with knee osteoarthritis (OA). However, a 2013 systematic review found only 13% met the activity recommendation of 150 minutes or more per week. The primary goal of this randomized controlled trail is to assess the efficacy of a physical activity counseling model, involving a group education session, the use of Fitbit Flex (a wireless physical activity tracking device), and online/telephone coaching by a physiotherapist (PT), to improve physical activity and reduce sedentary time in patients with knee OA. Engaging in regular physical activity can have the additional benefit of improving cognitive functioning.
Detailed Description
This project will address the Research Question: Can a non-intrusive physical activity tracking tool, combined with a group education session and advice from a physiotherapist (PT), increase physical activity in patients with knee osteoarthritis (OA)? The investigators focus on knee OA because it is common (affecting 1 in 10) and can be debilitating. Being physically active improves pain, mobility and quality of life; however, less than half of patients are active. Combining the best evidence in OA care and digital technology, the investigators propose a new model of care for improving physical activity in patients with OA. Our primary objective is to determine whether a model involving 1) a group education session, 2) the use of Fitbit Flex, a commercially available physical activity tracker, and 3) remote coaching by a PT can improve physical activity and reduce sedentary time in patients with knee OA. This model of care is in line with the goal of Mary Pack Arthritis Program (MPAP) to optimize activity independence of OA patients with MPAP's available human resources. In this proof-of-concept randomized controlled trial (RCT), the investigators hypothesize that compared to a control group (i.e. the Delayed Intervention group), participants in the Immediate Intervention Group will 1) increase moderate/vigorous physical activity (MVPA), 2) reduce sedentary time, 3) improve in OA disease status, and 4) improve in their self-efficacy of OA management, 4) To examine whether individuals in the Intervention Group will show improved cognitive function over the intervention period compared to the control group, and 5) To examine the pre-intervention factors that predict the degree to which individuals in the Intervention Group increase MVPA and reduce sedentary time. The investigators will use a mixed-methods approach, involving a RCT and in-depth interviews. The proof-of-concept study will employ a stepped wedge RCT design, whereby the intervention will be sequentially rolled out to participants over a number of time periods. The order in which individuals receive the intervention will be determined at random. The strength of this design is that it can properly address the efficacy question, while avoiding the dilemma of withholding the intervention to some participants, as in a parallel group design.
Investigators
Linda Li
Professor
University of British Columbia
Eligibility Criteria
Inclusion Criteria
- •Have a physician confirmed diagnosis of knee osteoarthritis OR are both 1) over 50, and 2) have experienced 4 weeks of pain, aching, or discomfort in or around the knee during the last year (equal to or more than 28 separate or consecutive days).
- •Have no previous diagnosis of rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, polymyalgia rheumatica, connective tissue diseases, fibromyalgia or gout.
- •Have no history of using disease-modifying anti-rheumatic drugs or gout medications.
- •Have no prior knee replacement surgery, and not on a waiting list for total knee replacement surgery.
- •Have no history of acute injury to the knee in the past 6 months.
- •Have not had surgery in the back, hip, knee, foot or ankle joints in the past 12 months.
- •Have an email address and daily access to a computer with internet connection.
- •Be able to attend a 1.5-hour education session at the Mary Pack Arthritis Centre.
- •Be able to attend a 1-hour assessment session at Vancouver General Hospital prior to beginning the study, and again 2 and 4 months later.
- •In addition, participants may be eligible (not required) to partake in a brain magnetic resonance imaging (MRI) assessment if they:
Exclusion Criteria
- •Have a body mass index of equal to or greater than 40
- •Have received a steroid injection in a knee in the last 6 months
- •Have received a hyaluronate injection in a knee in the last 6 months
- •Use medication that may impair activity tolerance (e.g. beta blockers)
- •Are at risk when exercising, as identified by the Physical Activity Readiness Questionnaire (PAR-Q)
Outcomes
Primary Outcomes
Time Spent in Moderate-to-Vigorous Physical Activity (MVPA)
Time Frame: Baseline; 2 months, 4 months and 6 months from baseline
Participants wore a SenseWear Mini accelerometer for 7 days at baseline, and Months 2, 4, and 6. We calculated the average daily time (minutes) spent in MVPA accumulated in bouts. A bout is defined as 10 or more consecutive minutes at the level of 3 or higher METs, with allowance for interruption of up to 1 minute below the threshold.
Secondary Outcomes
- KOOS - Symptoms(Baseline; 2 months, 4 months and 6 months from baseline)
- KOOS - Sports & Recreation(Baseline; 2 months, 4 months and 6 months from baseline)
- KOOS - Activity of Daily Living(Baseline; 2 months, 4 months and 6 months from baseline)
- KOOS - Quality of Life(Baseline; 2 months, 4 months and 6 months from baseline)
- Time Spent in Sedentary Behaviors(Change from baseline in time spent sedentary behaviors at 2 months, 4 months, and 6 months.)
- KOOS - Pain(Baseline; 2 months, 4 months and 6 months from baseline)
- Partners in Health Scale(Baseline; 2 months, 4 months and 6 months from baseline)