Abstract
BackgroundEngaging in sufficient levels of physical activity, guarding against sustained sitting, and maintaining a healthy body weight represent important lifestyle strategies for managing older adults’ chronic pain. Our first Mobile Health Intervention to Reduce Pain and Improve Health (MORPH) randomized pilot study demonstrated that a partially remote group-mediated diet and daylong activity intervention (ie, a focus on moving often throughout the day) can lead to improved physical function, weight loss, less pain intensity, and fewer minutes of sedentary time. We also identified unique delivery challenges that limited the program’s scalability and potential efficacy.ObjectiveThe purpose of the MORPH-II randomized pilot study is to refine the MORPH intervention package based on feedback from MORPH and evaluate the feasibility, acceptability, and preliminary efficacy of this revised package prior to conducting a larger clinical trial.MethodsThe MORPH-II study is an iteration on MORPH designed to pilot a refined framework, enhance scalability through fully remote delivery, and increase uptake of the daylong movement protocol through revised education content and additional personalized remote coaching. Older, obese, and low-active adults with chronic multisite pain (n=30) will be randomly assigned to receive a 12-week remote group-mediated physical activity and dietary weight loss intervention followed by a 12-week maintenance period or a control condition. Those in the intervention condition will partake in weekly social cognitive theory–based group meetings via teleconference software plus one-on-one support calls on a tapered schedule. They will also engage with a tablet application paired with a wearable activity monitor and smart scale designed to provide ongoing social and behavioral support throughout the week. Those in the control group will receive only the self-monitoring tools.ResultsRecruitment is ongoing as of January 2021.ConclusionsFindings from MORPH-II will help guide other researchers working to intervene on sedentary behavior through frequent movement in older adults with chronic pain.Trial RegistrationClinicalTrials.gov NCT04655001; https://clinicaltrials.gov/ct2/show/NCT04655001International Registered Report Identifier (IRRID)PRR1-10.2196/29013
Highlights
Physical activity is a key behavioral medicine for supporting quality of life [1] and managing chronic pain [2]
Obesity is powerfully associated with pain [11], and physical activity is considered a central component to weight management [12]
We illustrated this approach in the Mobile Intervention to Reduce Pain and Improve Health (MORPH) pilot trial wherein older adults with chronic pain attempted to lose weight and improve function through caloric restriction and increased physical activity via the accumulation of activity throughout the day [20]
Summary
Physical activity is a key behavioral medicine for supporting quality of life [1] and managing chronic pain [2]. Often exercise and sedentary behaviors are treated independently: Participation in a single daily bout of sustained and intense exercise leaves much of the day for prolonged sitting [9] and may even lead to compensatory increases in sitting [10] This is problematic from the perspective of weight management in older adults with chronic pain. A distributed movement goal aligns with the second edition of the United States Federal Physical Activity Guidelines [1], which emphasize a “move more, more often” approach to physical activity and remove the need to separately target structured exercise and sitting behaviors We illustrated this approach in the Mobile Intervention to Reduce Pain and Improve Health (MORPH) pilot trial wherein older adults with chronic pain attempted to lose weight and improve function through caloric restriction and increased physical activity via the accumulation of activity throughout the day [20]. We will explore the effect of MORPH-II for increasing time spent active while reducing sedentary time relative to a no-contact control
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