Abstract
BackgroundPhysical activity can improve health outcomes in people with knee osteoarthritis (OA); however, participation in physical activity is very low in this population.ObjectiveThe objective of our study was to assess the feasibility and preliminary efficacy of the use of wearables (Fitbit Flex) and telephone counselling by a physical therapist (PT) for improving physical activity in people with a physician-confirmed diagnosis of knee OA, or who have passed 2 validated criteria for early OA. MethodsWe conducted a community-based feasibility randomized controlled trial. The immediate group (n=17) received a brief education session by a physical therapist, a Fitbit Flex activity tracker, and a weekly telephone call for activity counselling with the physical therapist. The delayed group (n=17) received the same intervention 1 month later. All participants were assessed at baseline (T0), and the end of 1 month (T1) and 2 months (T2). Outcomes were (1) mean moderate to vigorous physical activity time, (2) mean time spent on sedentary behavior, (3) Knee Injury and Osteoarthritis Outcome Score (KOOS), and (4) Partners in Health Scale. Feasibility data were summarized with descriptive statistics. We used analysis of covariance to evaluate the effect of the group type on the outcome measures at T1 and T2, after adjusting for blocking and T0. We assessed planned contrasts of changes in outcome measures over measurement periods.ResultsWe identified 46 eligible individuals; of those, 34 (74%) enrolled and no one dropped out. All but 1 participant adhered to the intervention protocol. We found a significant effect, with the immediate intervention group having improved in the moderate to vigorous physical activity time and in the Partners in Health Scale at T0 to T1 compared with the delayed intervention group. The planned contrast of the immediate intervention group at T0 to T1 versus the delayed group at T1 to T2 showed a significant effect in the sedentary time and the KOOS symptoms subscale, favoring the delayed group.ConclusionsThis study demonstrated the feasibility of a behavioral intervention, supported by the use of a wearable device, to promote physical activity among people with knee OA.Trial RegistrationClinicalTrials.gov NCT02313506; https://clinicaltrials.gov/ct2/show/NCT02313506 (Archived by WebCite at http://www.webcitation.org/6r4P3Bub0)
Highlights
It is well known that physical activity can improve pain, mobility, and quality of life in people with knee osteoarthritis (OA) [1,2,3,4]
We found no significant effect in any outcome measures in the contrasts comparing the immediate group at T0 to T1 with delayed group at T0 to T2
This study demonstrated the feasibility of a behavioral intervention, supported by the use of a wearable device, to promote physical activity
Summary
It is well known that physical activity can improve pain, mobility, and quality of life in people with knee osteoarthritis (OA) [1,2,3,4]. The 2011 Canadian Community Health Survey found that 57% of people with arthritis were physically inactive during their leisure time, compared with 46% of those without arthritis (Multimedia Appendix 1). These findings concur with a 2013 systematic review that found that only 13% of people with OA met physical activity guidelines [10]. Physical activity can improve health outcomes in people with knee osteoarthritis (OA); participation in physical activity is very low in this population. We found a significant effect, with the immediate intervention group having improved in the moderate to vigorous physical activity time and in the Partners in Health Scale at T0 to T1 compared with the delayed intervention group. Trial Registration: ClinicalTrials.gov NCT02313506; https://clinicaltrials.gov/ct2/show/NCT02313506 (Archived by WebCite at http://www.webcitation.org/6r4P3Bub0)
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