Activity pacing for osteoarthritis symptom management: study design and methodology of a randomized trial testing a tailored clinical approach using accelerometers for veterans and non-veterans.
Activity pacing for osteoarthritis symptom management: study design and methodology of a randomized trial testing a tailored clinical approach using accelerometers for veterans and non-veterans.
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DOI：
10.1186/1471-2474-12-177
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发表时间：
2011-08-02
影响因子：
2.3
通讯作者：
Williams DA
中科院分区：
文献类型：
--
作者：
Murphy SL;Lyden AK;Clary M;Geisser ME;Yung RL;Clauw DJ;Williams DA
骨关节炎（OA）是一种常见的慢性疾病，也是导致成人残疾的主要原因。对于膝和髋关节炎患者，症状（如疼痛和疲劳）会影响活动和身体活动。尽管症状管理是膝关节和髋关节骨关节炎治疗的基石，但在临床护理的背景下，由康复专业人员提供的行为干预措施来解决症状如何影响日常活动参与的证据有限。活动起搏是一种人们学习预先计划休息时间以避免症状恶化的策略，作为多组分干预的一部分是有效的，但尚未作为OA的单独干预或使用加速度计的定制治疗进行过测试。在一项初步研究中，我们发现接受量身定制的活动节奏干预的参与者减少了日常活动的疲劳干扰。我们正在进行全面的试验。本文描述了我们对一项试验的方法和基本原理，该试验评估了由职业治疗师领导的针对成人膝关节和髋关节OA的量身定制的活动起搏干预。干预使用在基线家庭监测期间佩戴的手腕加速计来收集最近的症状和身体活动模式，并根据症状与身体活动的关系来定制活动步调指导。在基线后10周和6个月，我们将检查与一般活动起搏组和常规护理组相比，量身定制的活动起搏干预对疲劳、疼痛和身体功能的有效性。我们还将评估量身定制的活动起搏对身体活动（PA）的影响。在日常生活活动表现中管理OA症状对膝关节和髋关节OA患者来说是具有挑战性的，但很少有临床干预措施解决这个问题。本试验中测试的活动起搏干预旨在帮助人们调节活动水平，减少因活动过多或过少而引起的症状发作。作为这项试验的结果，我们将能够确定活动起搏是否比常规护理更有效，以及在干预组中，单独定制的方法是否比一般的活动起搏方法更能改善疲劳和疼痛。ClinicalTrials.gov: NCT01192516
Osteoarthritis (OA) is a prevalent chronic disease and a leading cause of disability in adults. For people with knee and hip OA, symptoms (e.g., pain and fatigue) can interfere with mobility and physical activity. Whereas symptom management is a cornerstone of treatment for knee and hip OA, limited evidence exists for behavioral interventions delivered by rehabilitation professionals within the context of clinical care that address how symptoms affect participation in daily activities. Activity pacing, a strategy in which people learn to preplan rest breaks to avoid symptom exacerbations, has been effective as part of multi-component interventions, but hasn't been tested as a stand-alone intervention in OA or as a tailored treatment using accelerometers. In a pilot study, we found that participants who underwent a tailored activity pacing intervention had reduced fatigue interference with daily activities. We are now conducting a full-scale trial. This paper provides a description of our methods and rationale for a trial that evaluates a tailored activity pacing intervention led by occupational therapists for adults with knee and hip OA. The intervention uses a wrist accelerometer worn during the baseline home monitoring period to glean recent symptom and physical activity patterns and to tailor activity pacing instruction based on how symptoms relate to physical activity. At 10 weeks and 6 months post baseline, we will examine the effectiveness of a tailored activity pacing intervention on fatigue, pain, and physical function compared to general activity pacing and usual care groups. We will also evaluate the effect of tailored activity pacing on physical activity (PA). Managing OA symptoms during daily life activity performance can be challenging to people with knee and hip OA, yet few clinical interventions address this issue. The activity pacing intervention tested in this trial is designed to help people modulate their activity levels and reduce symptom flares caused by too much or too little activity. As a result of this trial, we will be able to determine if activity pacing is more effective than usual care, and among the intervention groups, if an individually tailored approach improves fatigue and pain more than a general activity pacing approach. ClinicalTrials.gov: NCT01192516
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影响因子：
7
作者：
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通讯作者：
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