Capitalizing on the teachable moment: osteoarthritis physical activity and exercise net for improving physical activity in early knee osteoarthritis.
Capitalizing on the teachable moment: osteoarthritis physical activity and exercise net for improving physical activity in early knee osteoarthritis.
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DOI：
10.2196/resprot.2553
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发表时间：
2013-05-09
影响因子：
1.7
通讯作者：
Esdaile JM
中科院分区：
文献类型：
--
作者：
Li LC;Lineker S;Cibere J;Crooks VA;Jones CA;Kopec JA;Lear SA;Pencharz J;Rhodes RE;Esdaile JM
实践指南强调使用运动和减肥作为治疗膝骨关节炎（OA）的第一线。然而，只有不到一半的轻度OA患者参加中等强度的体育活动。鉴于体育活动已被证明可以减轻疼痛，改善生活质量，并有可能减少关节损伤的进展，许多OA患者错过了这种廉价干预的好处。本研究的目的是：(1)为以前未确诊的膝关节OA患者开发一种行为理论为基础的网络干预，称为骨关节炎身体活动和运动网（OPEN），(2)通过概念验证研究评估OPEN网站在改善身体活动参与方面的功效。OPEN是基于计划行为理论开发的。加拿大不列颠哥伦比亚省正在进行一项概念验证、单盲随机对照试验，以评估这种在线干预的有效性。我们目前正在招募参与者，并计划使用一套经过验证的标准招募252名久坐未确诊的膝关节OA患者。一半的参与者将被随机分配使用OPEN，并收到OA教育小册子。另一半只会收到小册子。参与者将在基线、3个月和6个月完成一份在线问卷，内容涉及他们参与体育活动、健康相关生活质量和动机结果。此外，我们将在参与者的子样本中进行有氧体能测试（每个研究组n=20）。在初步分析中，我们将使用逻辑回归来比较两组中报告身体活动达到或超过推荐水平的参与者的比例，并对基线测量、年龄和性别进行调整。在骨性关节炎患者倾向于更积极地采取积极的生活方式（即骨性关节炎的早期阶段）时，本研究评估了一种理论知情的行为干预。我们的方法，包括早期膝关节OA的识别，然后立即进行直接针对缺乏身体活动的在线干预，可以很容易地在整个社区实施。我们的在线干预直接针对关节损伤较轻的时候缺乏运动的患者。如果发现OPEN在改变长期身体活动行为方面是有效的，它将为促进早期诊断和实施生活方式干预提供进一步的机会。Clinicaltrial.gov: NCT01608282;http://clinicaltrials.gov/ct2/show/NCT01608282（由WebCite在http://www.webcitation.org/6G7sBBayI存档）
Practice guidelines emphasize the use of exercise and weight reduction as the first line of management for knee osteoarthritis (OA). However, less than half of the people with mild OA participate in moderate intensity physical activity. Given that physical activities have been shown to reduce pain, improve quality of life, and have the potential to reduce the progression of joint damage, many people with OA are missing the benefits of this inexpensive intervention. The objectives of this study are (1) to develop a behavioral theory-informed Internet intervention called Osteoarthritis Physical Activity & Exercise Net (OPEN) for people with previously undiagnosed knee OA, and (2) to assess the efficacy of the OPEN website for improving physical activity participation through a proof-of-concept study. OPEN was developed based on the theory of planned behavior. Efficacy of this online intervention is being assessed by an ongoing proof-of-concept, single-blind randomized controlled trial in British Columbia, Canada. We are currently recruiting participants and plan to recruit a total of 252 sedentary people with previously undiagnosed knee OA using a set of validated criteria. Half of the participants will be randomized to use OPEN and receive an OA education pamphlet. The other half only will receive the pamphlet. Participants will complete an online questionnaire at baseline, 3 months, and 6 months about their participation in physical activities, health-related quality of life, and motivational outcomes. In addition, we will perform an aerobic fitness test in a sub-sample of participants (n=20 per study arm). In the primary analysis, we will use logistic regression to compare the proportion of participants reporting being physically active at or above the recommended level in the 2 groups, adjusting for baseline measurement, age, and sex. This study evaluates a theory-informed behavioral intervention at a time when people affected with OA tend to be more motivated to adopt an active lifestyle (ie, at the early stage of OA). Our approach, which consisted of the identification of early knee OA followed immediately by an online intervention that directly targets physical inactivity, can be easily implemented across communities. Our online intervention directly targets physical inactivity at a time when the joint damage tends to be mild. If OPEN is found to be effective in changing long-term physical activity behaviors, it opens further opportunities to promote early diagnosis and to implement lifestyle interventions. Clinicaltrial.gov: NCT01608282; http://clinicaltrials.gov/ct2/show/NCT01608282 (Archived by WebCite at http://www.webcitation.org/6G7sBBayI)