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Clinical Trials/NCT03740412
NCT03740412
Completed
Not Applicable

Intervention to Reduce Sedentary Time in Older Adults Undergoing Orthopaedic Surgery: a Feasibility Study (INTEREST)

University of Birmingham1 site in 1 country35 target enrollmentJanuary 29, 2018

Overview

Phase
Not Applicable
Intervention
Not specified
Conditions
Orthopedic Disorder
Sponsor
University of Birmingham
Enrollment
35
Locations
1
Primary Endpoint
Study uptake rates (as % of those approached who are randomised, recruitment rates (N/mth)
Status
Completed
Last Updated
6 years ago

Overview

Brief Summary

The aim of this study is to investigate the feasibility of an intervention to reduce sedentary behaviour in older adults waiting for hip and knee replacements. The study will be a randomised controlled trial design, including 2:1 randomisation into an intervention and usual care group respectively. A target of n=45 patients ≥60 years will be recruited from Russells Hall Hospital, Dudley, UK, approximately 8-10 weeks before surgery, assisted by research nurses. The variable-length intervention, informed by Self-Determination Theory (SDT), will be composed of multiple behaviour change techniques, namely motivational interviewing, individualised feedback on sedentariness, goal-setting, environmental modification, self-monitoring, and social support. Assessments will occur at baseline, 1 week pre-surgery, and 6 weeks post-surgery. The primary outcome will be the feasibility of the trial, assessed quantitatively using study statistics, and with mixed-methods assessment of acceptability, practicality, adaption, satisfaction, and safety via questionnaires given to participants. Exploratory outcomes will include physical function, cardiometabolic biomarkers, measurement of SDT constructs, and both objective and subjective measurement daily activity and sedentariness. The study will last up to 18 weeks per participant.

Detailed Description

The aim of this study is to investigate the feasibility of an intervention to reduce sedentary behaviour in n=45 older adults undergoing orthopaedic surgery, at Russells Hall Hospital, Dudley, Birmingham, UK. Recruitment will be via screening of surgery lists followed by direct contact with potentially eligible participants. The intervention is designed utilising Self Determination Theory. It is designed to have multiple components: incorporating individualised feedback on sitting time, education about sedentary behaviour, individualised goal-setting and environmental modification according to each participant's own behavioural patterns and capabilities, motivational interviewing, and biweekly phone calls. Due to variation in surgery times, the intervention will be variable but can last up to 18 weeks. Each participant will undertake 3-5 visits depending on whether they are in the control group (n=3 visits) or intervention group (n=5 visits). The intervention group will undergo baseline assessments, two intervention meetings, pre-surgical assessments, and a 6-week post-surgical follow up. These visits will occur in different weeks for each participant due to the variability of surgery, however visit 2 will occur 1 week after visit 1. Visit 3 will occur shortly thereafter but may also be combined with visit 2. Visit 4 will occur the week prior to surgery, which is intended to be 6-10 weeks after baseline. Visit 5 occurs 6 weeks post-surgery, which should be 12-18 weeks post-baseline. The primary outcome measure will be feasibility, assessed quantitatively with study statistics. Secondary outcome will be mixed-methods assessment of feasibility via bespoke participant questionnaires. Exploratory outcomes will cover a number of mental and physical health variables, including blood measures to assess cardiometabolic biomarkers, as well as physical function using the short physical performance battery (SPPB). Surgical recovery will be assessed using the Oxford Hip/Knee score and the SPPB. The results of this feasibility study will serve to aid the design of a definitive trial of an intervention to reduce sedentary behaviour in this population.

Registry
clinicaltrials.gov
Start Date
January 29, 2018
End Date
April 15, 2019
Last Updated
6 years ago
Study Type
Interventional
Study Design
Parallel
Sex
All

Investigators

Responsible Party
Sponsor

Eligibility Criteria

Inclusion Criteria

  • Men and women aged ≥60 years.
  • Listed for elective hip or knee surgery.
  • Capable of providing informed consent.
  • Regular access to a phone at pre-specified times.
  • Able to speak English.

Exclusion Criteria

  • Neuromuscular impairments that preclude participating in physical activity, visual, hearing, or moderate/ severe cognitive impairments as indicated by the research nurse prior to recruitment.
  • Significant co-morbid disease that would pose a safety threat, affect blood measures significantly, or impair ability to participate such as coronary artery disease, severe hypertension, peripheral vascular disease, stroke, congestive heart failure, chronic obstructive pulmonary disease, insulin-dependent diabetes, psychiatric disease, renal disease, liver disease, or an active cancer other than skin cancer.
  • Working more than 2 days per week.
  • Unwillingness or inability to comply with the intervention.

Outcomes

Primary Outcomes

Study uptake rates (as % of those approached who are randomised, recruitment rates (N/mth)

Time Frame: Assessed post-study-endpoint (up to month 18)

Study uptake rates (as % of those approached who are randomised, recruitment rates (N/mth)

Acceptability of intervention for participants

Time Frame: Pre-surgery (visit 4, up to week 10), post-surgery (visit 5, up to week 18)

Assessed by custom-made feasibility questionnaire which uses a number of closed and open questions. Closed questions include (Likert 1-5 scale): How easy was it to achieve your goals physically? How easy was it to achieve your goals mentally? Have you found taking part in the study burdensome?

Percentage of participants whose surgery is scheduled up to 2 weeks prior to the end of the intervention

Time Frame: Assessed post-study-endpoint (up to month 18)

Percentage of participants whose surgery is scheduled up to 2 weeks prior to the end of the intervention

Percentage of participants whose surgery is scheduled up to three weeks after the end of the intervention

Time Frame: Assessed post-study-endpoint (up to month 18)

Percentage of participants whose surgery is scheduled up to three weeks after the end of the intervention

Percentage of participants whose surgery is cancelled or delayed for too long

Time Frame: Assessed post-study-endpoint (up to month 18)

Percentage of participants whose surgery is delayed beyond 3 weeks post-intervention

Practicality of intervention for participants

Time Frame: Pre-surgery (visit 4, up to week 10), post-surgery (visit 5, up to week 18)

Assessed by custom-made feasibility questionnaires, using both closed and open questions. Closed questions include (1-5 Likert scale): Could you have changed your goals to make them more achievable? Which part(s) of the intervention did you find most difficult?

Intervention adherence to goals

Time Frame: Assessed post-study-endpoint (up to month 18)

Self-recording by participants of goal achievement on a scale of 1-5, recorded each week for the first 6 weeks of the intervention in their goal-setting booklet.

Retention rates (% of participants randomised who provide data at follow-up)

Time Frame: Assessed post-study-endpoint (up to month 18)

Assessed by the number of participants who attend the follow-up visit (visit 5, 6 weeks post-surgery)

Participant satisfaction with the study

Time Frame: Pre-surgery (visit 4, up to week 10), post-surgery (visit 5, up to week 18)

Whether patients are satisfied, as assessed by feasibility questionnaires given at visit 4 (week prior to surgery) and visit 5 (week post-surgery). This included open and closed questions. Closed questions include (Likert scale 1-5): Which part(s) of the intervention did you find most enjoyable? How would you rate your overall satisfaction with the study? How likely would you be to suggest taking part in such a study to friends or family? How likely are you to continue working towards your goals in the future?

Patient perception of the safety of the study as assessed by questionnaire

Time Frame: Pre-surgery (visit 4, up to week 10), post-surgery (visit 5, up to week 18)

Any change in patient safety as assessed by custom-made feasibility questionnaires. This includes closed and open questions. Closed questions include (Likert 1-3 scale): Do you feel that taking part in the study has exposed you to more pain? Do you feel that taking part in the study has exposed you to risk of physical harm?

Secondary Outcomes

  • Sitting time(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10), post-surgery (visit 5, up to week 18))
  • Stepping time(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10), post-surgery (visit 5, up to week 18))
  • Measure of Older Adults' Sedentary Time (MOST)(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10), post-surgery (visit 5, up to week 18))
  • International Physical Activity Questionnaire (IPAQ) Short Form(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10))
  • Waist to hip ratio(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10))
  • Low density lipoprotein concentration(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10))
  • Dehydroepiandrosterone sulfate (DHEAS) concentration(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10))
  • Sit-to-stand transitions(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10), post-surgery (visit 5, up to week 18))
  • Triglyceride concentration(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10))
  • Cortisol concentration(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10))
  • Short Physical Performance Battery (SPPB)(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10), post-surgery (visit 5, up to week 18))
  • EuroQol five dimensions questionnaire (EQ-5D)(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10), post-surgery (visit 5, up to week 18))
  • EQ-VAS(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10), post-surgery (visit 5, up to week 18))
  • Basic Psychological Needs Scale(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10), post-surgery (visit 5, up to week 18))
  • Standing time(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10), post-surgery (visit 5, up to week 18))
  • Quantity of sedentary bouts >30 minutes(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10), post-surgery (visit 5, up to week 18))
  • Katz Activites of Daily Living(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10))
  • Height(Baseline (visit 1, week 1))
  • Short Form Mini Nutritional Assessment (SF-MNA)(Baseline (visit 1, week 1))
  • Albumin concentration(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10))
  • C-Reactive Protein concentration(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10))
  • Interleukin 6 concentration(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10))
  • Tumor Necrosis Factor Alpha concentration(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10))
  • Transferrin concentration(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10))
  • Oxford Hip/Knee Score(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10), post-surgery (visit 5, up to week 18))
  • Body weight(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10), post-surgery (visit 5, up to week 18))
  • Body mass index(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10))
  • High Density Lipoprotein concentration(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10))
  • Vitamin D level(Baseline (visit 1, week 1), Pre-surgery (visit 4, up to week 10))

Study Sites (1)

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