Group-mediated Physical Activity Promotion and Mobility in Sedentary Patients with Knee Osteoarthritis: Results from the IMPACT-Pilot Trial
Group-mediated Physical Activity Promotion and Mobility in Sedentary Patients with Knee Osteoarthritis: Results from the IMPACT-Pilot Trial
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DOI：
10.3899/jrheum.140054
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发表时间：
2014-10-01
影响因子：
3.9
通讯作者：
Rejeski, W. Jack
中科院分区：
文献类型：
--
作者：
Focht, Brian C.;Garver, Matthew J.;Rejeski, W. Jack
目标。比较群体介导的认知行为运动干预（GMCB）与传统的以中心为基础的运动疗法（TRAD）对久坐不动的膝骨关节炎（OA）患者身体活动（PA）和活动能力的客观评估水平的影响。改善膝关节骨性关节炎的身体活动维持试验- pilot （IMPACT-P）是一项为期12个月、双组、单盲、随机对照的试验研究，旨在比较GMCB和TRAD对80例自述日常活动困难的久坐膝关节炎患者的影响[平均年龄63.5岁，84%为女性，平均体重指数（BMI） 32.7 kg/m(2)]。在基线、3个月和12个月时，研究人员对受试者的治疗分配不知情，获得了PA （LIFECORDER Plus加速度计）和活动能力（400米步行）的客观评估。治疗意图2（治疗：GMCB和TRAD） x 2（时间：3个月和12个月）对照基线、年龄、性别和bmi调整后结果变化的协方差分析表明，GMCB干预相对于TRAD显著增加了PA (p < 0.01)，但在活动能力方面有了更有利的改善（p = 0.09）。偏相关分析还显示，PA变化与随访3个月（r = -0.51, p < 0.01）和随访12个月（r = -0.40, p < 0.01）时的400米步行表现显著相关。IMPACT-P试验的结果表明，与TRAD相比，GMCB治疗导致PA的显著改善和不显著但更有利的活动能力变化。
Objective. To compare the effects of a group-mediated cognitive behavioral exercise intervention (GMCB) with traditional center-based exercise therapy (TRAD) on objectively assessed levels of physical activity (PA) and mobility in sedentary patients with knee osteoarthritis (OA).Methods. The Improving Maintenance of Physical Activity in Knee Osteoarthritis Trial-Pilot (IMPACT-P) was a 12-month, 2-arm, single-blind, randomized controlled pilot study designed to compare the effects of GMCB and TRAD on 80 sedentary patients with knee OA with self-reported difficulty in daily activities [mean age 63.5 yrs, 84% women, mean body mass index (BMI) 32.7 kg/m(2)]. Objective assessments of PA (LIFECORDER Plus Accelerometer) and mobility (400-m walk) were obtained at baseline, 3 months, and 12 months by study personnel blinded to participants' treatment assignment.Results. Intent to treat 2 (treatment: GMCB and TRAD) x 2 (time: 3 mos and 12 mos) analyses of covariance of controlling for baseline, age, sex, and BMI-adjusted change in the outcomes demonstrated that the GMCB intervention yielded significantly greater increases in PA (p < 0.01) and a nonsignificant yet more favorable improvement in mobility (p = 0.09) relative to TRAD. Partial correlation analyses also revealed that change in PA was significantly correlated with the 400-m walk performance at 3-month (r = -0.51, p < 0.01) and 12-month (r = -0.40, p < 0.01) followup assessments.Conclusion. Findings from the IMPACT-P trial suggest that the GMCB treatment resulted in significantly greater improvement in PA and nonsignificant yet more favorable change in mobility relative to TRAD.