Activity, Rheumatoid and Osteoarthritis, and Weight Management



Status:Completed
Conditions:Arthritis, Arthritis, Osteoarthritis (OA), Rheumatoid Arthritis
Therapuetic Areas:Rheumatology
Healthy:No
Age Range:18 - Any
Updated:4/21/2016
Start Date:October 2003
End Date:February 2006

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Weight Management, Physical Activity, Less Disability in Rheumatoid and Osteoarthritis

The purpose of the study was to implement well-developed guidelines for arthritis management
beyond acute medical management to independent community living by modifying existing weight
management and physical activity promotion programs for people with disabling arthritis.

Our hypotheses were:

1. Existing individual, health care system, and community strategies to promote physical
activity and weight management can effectively be modified and expanded to include
those with debilitating joint diseases.

2. People with inflammatory joint disease can have healthy physical activity levels and
weight at home and in the community.

3. The effect of these interventions will be higher quality of life, lower depression
rates, modest pain levels, and functional independence.

Park Nicollet Clinic and the Institute for Clinical Systems Integration have spent several
million dollars developing evidence-based care guidelines and intervention strategies for a
wide range of common illnesses. Included in the degenerative joint disease guideline are
recommendations for the management of two inter-related risk factors for increased
disability: obesity and lack of physical activity. This application seeks to integrate
disability prevention programs into the post-acute management of rheumatoid and
osteoarthritis.

Our specific aims are to: (1) Modify well-established weight management techniques and
physical activity promotion interventions according to Institute for Clinical Systems
Integration recommendations for use by the broader community of individuals with potentially
disabling rheumatoid and osteoarthritis; (2) Implement these interventions within a diverse
patient population identified within an integrated health care system; (3) Demonstrate the
short and long term impact of these interventions on patients suffering from debilitating
joint disease; and (4) Facilitate incorporation of these interventions by other communities
and clinical settings to enhance the longer-term well being of those with disabilities.

To achieve our aims, we will modify existing weight management and physical activity
promotion strategies across the continuum of care. Through patient focus groups, a clinical
advisory board, a community advisory board, and pilot testing, key stakeholders will help
assure effective program design and implementation strategies as well as development of
sustainable interventions. Using pre- and post-intervention surveys and simple measures of
physical ability and weight, we will demonstrate the effect of these interventions on
physical activity levels and weight; assess the effect of the interventions on pain, quality
of life, depression, and functional capacity in those diagnosed with rheumatoid or
osteoarthritis; and document the implementation strategies for the community interventions.

Our aims and hypotheses are consistent with the overarching goals of Healthy People 2010:
(1) to increase quality and years of healthy life and (2) to eliminate health disparities.
We address two focus areas, (2) arthritis and (6) disability and secondary conditions. Our
intervention targets two of the leading health indicators: physical activity and overweight
and obesity.

Inclusion Criteria:

- Adult men and women

- A medical visit at one of six Park Nicollet Health System sites from November 2003
through June 2004.

- ICD-9 visit code of 714.0, 715.90 or 715.95 through 715.97

- Patient's clinician provided written consent to invite participation

- Patients had previously consented to be contacted for research purposes.

Exclusion Criteria:

- The patient was unaware of a medical diagnosis of arthritis.

- They did not report having a medical provider they could call with arthritis-related
questions

- Arthritis-related problems for less than nine months duration for rheumatoid
arthritis, less than three months for osteoarthritis.

- Scheduled for surgery.

- History of lower extremity joint replacement.

- Less than daily arthritis pain or problems.

- History of chest pain or medically restricted activity.

- Unable to participate for 12 months.
We found this trial at
1
site
St Louis Park, Minnesota 55416
?
mi
from
St Louis Park, MN
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