Collaborative-care Intervention to Promote Physical Activity After Total Knee Arthroplasty
| Status: | Completed |
|---|---|
| Conditions: | Arthritis, Osteoarthritis (OA) |
| Therapuetic Areas: | Rheumatology |
| Healthy: | No |
| Age Range: | 50 - 75 |
| Updated: | 2/24/2018 |
| Start Date: | February 2014 |
| End Date: | February 2018 |
The investigators have learned that knee replacement patients are not more physically active
after surgery. This is true even though their pain is less compared to before surgery. This
low level of physical activity is not healthy. It can increase the chances of weight gain,
which can create other issues. It can also lessen physical function. Some studies have looked
at physical activity feedback systems to increase how active people are. Studies have
investigated face to face patient group meetings for this,too. These systems and meetings can
increase physical activity. The investigators will study the effects of a physical activity
monitors with group meetings after knee replacement. The investigators hypothesize that
physical activity levels and physical function will increase. The investigators goal is to
help knee replacement patients lead healthier lives and maintain or enhance their physical
function.
after surgery. This is true even though their pain is less compared to before surgery. This
low level of physical activity is not healthy. It can increase the chances of weight gain,
which can create other issues. It can also lessen physical function. Some studies have looked
at physical activity feedback systems to increase how active people are. Studies have
investigated face to face patient group meetings for this,too. These systems and meetings can
increase physical activity. The investigators will study the effects of a physical activity
monitors with group meetings after knee replacement. The investigators hypothesize that
physical activity levels and physical function will increase. The investigators goal is to
help knee replacement patients lead healthier lives and maintain or enhance their physical
function.
More than 650,000 total knee arthroplasties (TKAs) are performed annually to alleviate pain
and disability associated with osteoarthritis (OA); a chronic, degenerative condition that
compromises the quality of life of 37% of adults over age 60. With the aging of the
population, an estimated 3.5 million TKAs will be performed annually by 2030. Despite
improvements in pain and self-reported function, physical activity after TKA remains at
pre-operative, sedentary levels (<5,000 steps/day). Physical activity in TKA confers powerful
protective effects against common post-surgical sequelae including increased weight gain
(mean=6.4 kg, 2 years post TKA), decreased functional performance, increased risk/progression
of co-morbid conditions (e.g. type 2 diabetes mellitus, cardiovascular disease), and
progression of knee and hip osteoarthritis which may necessitate additional joint replacement
in the contralateral limb. An intervention aimed at improved self-management of physical
activity may aid patients in overcoming habitual lifestyle patterns of low physical activity
secondary to knee pain prior to TKA.
Recent investigations on the effects of real-time, user-friendly, electronic physical
activity feedback (PAF) systems and face-to-face (FTF) patient group meetings aimed to
promote self-management of physical activity suggest that such interventions can successfully
increase physical activity. Therefore, the investigators propose a randomized, controlled
trial to assess efficacy and feasibility of a physical activity intervention combined with
FTF group meetings (PAF+FTF) initiated within one month of patients' discharge from
outpatient rehabilitation for TKA compared to a control group receiving standard care (CON).
This type of intervention is surprisingly novel to this patient population and is not common
practice in rehabilitation following TKA.
and disability associated with osteoarthritis (OA); a chronic, degenerative condition that
compromises the quality of life of 37% of adults over age 60. With the aging of the
population, an estimated 3.5 million TKAs will be performed annually by 2030. Despite
improvements in pain and self-reported function, physical activity after TKA remains at
pre-operative, sedentary levels (<5,000 steps/day). Physical activity in TKA confers powerful
protective effects against common post-surgical sequelae including increased weight gain
(mean=6.4 kg, 2 years post TKA), decreased functional performance, increased risk/progression
of co-morbid conditions (e.g. type 2 diabetes mellitus, cardiovascular disease), and
progression of knee and hip osteoarthritis which may necessitate additional joint replacement
in the contralateral limb. An intervention aimed at improved self-management of physical
activity may aid patients in overcoming habitual lifestyle patterns of low physical activity
secondary to knee pain prior to TKA.
Recent investigations on the effects of real-time, user-friendly, electronic physical
activity feedback (PAF) systems and face-to-face (FTF) patient group meetings aimed to
promote self-management of physical activity suggest that such interventions can successfully
increase physical activity. Therefore, the investigators propose a randomized, controlled
trial to assess efficacy and feasibility of a physical activity intervention combined with
FTF group meetings (PAF+FTF) initiated within one month of patients' discharge from
outpatient rehabilitation for TKA compared to a control group receiving standard care (CON).
This type of intervention is surprisingly novel to this patient population and is not common
practice in rehabilitation following TKA.
Inclusion Criteria:
- undergone unilateral total knee arthroplasty
Exclusion Criteria:
- severe contralateral leg osteoarthritis (>4/10 with stair climbing)
- unstable orthopaedic condition that limits function
- neurological conditions that affect muscle function
- vascular or cardiac conditions that limit function
We found this trial at
1
site
Aurora, Colorado 80045
Principal Investigator: Jennifer Stevens-Lapsley, MPT, PhD
Phone: 303-724-9590
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