Although total knee arthroplasty is an effective intervention for decreasing knee pain and improving physical function, physical activity levels remain low up to a year after surgery. This study will use mobile-health technology to deliver an intervention designed to improve physical activity behavior for Veterans recovering from total knee arthroplasty. The study will assess the effectiveness of using behavior-change intervention as a supplement to conventional rehabilitation to improve physical activity. The intervention will be delivered using home-based tablet computers for Veterans to have remote interaction with the researcher and real-time physical activity feedback from a wrist-worn activity sensor.
This randomized clinical trial will assess the efficacy of using physical activity behavior change intervention for Veterans recovering from total knee arthroplasty. Testing will occur at baseline (before surgery), at intervention midpoint (8 weeks after surgery), end of intervention (14 weeks after surgery), and 24 weeks after intervention. The primary outcome is accelerometer-assessed daily step count. Secondary outcomes include the percent time engaged in standing and walking activity and physical function (Six-Minute Walk, 30-Second Chair-Stand Test, Timed Up-and-Go, Western Ontario and McMaster Universities Osteoarthritis Index, and the Veterans RAND 12-Item Health Survey.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
114
Home-based weekly sessions (30 min) using behavior change methods for promoting physical activity. Sessions will occur using home-based computer tablets for real-time video interface between the participant and researcher. Participants will wear wrist-mounted activity sensors with direct physical activity feedback during the intervention period to allow for behavioral feedback and action planning.
Conventional rehabilitation with supplemental 10 telerehabilitation sessions that match the frequency and duration of the experimental arm. Attention control intervention provided as 10 telerehabilitation sessions of non-physical activity related education-only sessions.
Rocky Mountain Regional VA Medical Center, Aurora, CO
Aurora, Colorado, United States
Free-living Daily Step Count
Accelerometer-based measurement of free-living daily step count
Time frame: End of intervention (14 weeks)
30-Second Chair-Stand Test W14
Physical function test that assesses the number of sit-stand-sit transitions that a participant performs in the span of 30 seconds.
Time frame: End of intervention (14 weeks)
30-Second Chair-Stand Test W38
Physical function test that assesses the number of sit-stand-sit transitions that a participant performs in the span of 30 seconds.
Time frame: 24 weeks after intervention (week 38 of study)
Six-Minute Walk Test W14
Physical function test measuring the total distance walked in a span of six minutes.
Time frame: End of intervention (14 weeks)
Six-Minute Walk Test W38
Physical function test measuring the total distance walked in a span of six minutes.
Time frame: 24 weeks after intervention (week 38 of study)
Timed Up-and-Go Test W14
A physical performance measure that includes rising from a chair, walking 3 meters, turning 180 degrees, returning to chair, and sitting.
Time frame: End of intervention (14 weeks)
Timed Up-and-Go Test W38
A physical performance measure that includes rising from a chair, walking 3 meters, turning 180 degrees, returning to chair, and sitting.
Time frame: 24 weeks after intervention (week 38 of study)
Western Ontario and McMaster Universities Osteoarthritis Index W14
Self-report health status measure of pain, stiffness, and function for people with osteoarthritis of the hip or knee. A higher score indicates worse outcome with the Total Score range from 0-96. A positive change indicates worse outcome and a negative change indicates a better outcome across time points.
Time frame: End of intervention (14 weeks)
Western Ontario and McMaster Universities Osteoarthritis Index W38
Self-report health status measure of pain, stiffness, and function for people with osteoarthritis of the hip or knee. A higher score indicates worse outcome with the Total Score range from 0-96. A positive change indicates worse outcome and a negative change indicates a better outcome across time points.
Time frame: 24 weeks after intervention (week 38 of the study)
Veterans RAND 12-Item Health Survey Physical Component W14
A self-report assessment of health-related quality of life assessing the domains of physical functioning, role-physical, bodily pain, general health perceptions, vitality, social functioning, role-emotional, and mental health. All items are scored so that a high score defines a more favorable health state. In addition, each item is scored on a 0 to 100 range so that the lowest and highest possible scores are 0 and 100, respectively. Scores represent the percentage of total possible score achieved.
Time frame: End of intervention (14 weeks)
Veterans RAND 12-Item Health Survey Physical Component W38
A self-report assessment of health-related quality of life assessing the domains of physical functioning, role-physical, bodily pain, general health perceptions, vitality, social functioning, role-emotional, and mental health. All items are scored so that a high score defines a more favorable health state. In addition, each item is scored on a 0 to 100 range so that the lowest and highest possible scores are 0 and 100, respectively. Scores represent the percentage of total possible score achieved.
Time frame: 24 weeks after intervention (week 38 of study)
Veterans RAND 12-Item Health Survey Mental Component W14
A self-report assessment of health-related quality of life assessing the domains of physical functioning, role-physical, bodily pain, general health perceptions, vitality, social functioning, role-emotional, and mental health. All items are scored so that a high score defines a more favorable health state. In addition, each item is scored on a 0 to 100 range so that the lowest and highest possible scores are 0 and 100, respectively. Scores represent the percentage of total possible score achieved.
Time frame: End of intervention (14 weeks)
Veterans RAND 12-Item Health Survey Mental Component W38
A self-report assessment of health-related quality of life assessing the domains of physical functioning, role-physical, bodily pain, general health perceptions, vitality, social functioning, role-emotional, and mental health. All items are scored so that a high score defines a more favorable health state. In addition, each item is scored on a 0 to 100 range so that the lowest and highest possible scores are 0 and 100, respectively. Scores represent the percentage of total possible score achieved.
Time frame: 24 weeks after intervention (week 38 of study)
Free-living Daily Step Count W38
Accelerometer-based measurement of free-living daily step count
Time frame: 24 weeks after intervention (week 38 of study)
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