Reducing Sedentary Time Using an Innovative mHealth Intervention Among Total Knee Replacement Patients

使用创新的移动医疗干预措施减少全膝关节置换患者的久坐时间

• 批准号: 10339457
• 负责人: Christine Ann Pellegrini
• 金额: $ 15.6万
• 依托单位: UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10339457
• 关键词: Accelerometer; Accounting; Adherence; Adult; Behavior; Cellular Phone; Clinical Trials; Control Groups; Data; Data Collection; Dose; Education; Face; General Population; Goals; Health Care Costs; Health behavior; Impairment; Individual; Interruption; Intervention; Knee Osteoarthritis; Lead; Light; Light Exercise; Maintenance; Measures; Monitor; Motivation; Non-Insulin-Dependent Diabetes Mellitus; Operative Surgical Procedures; Outcome; Outcome Study; Pain; Participant; Patients; Physical Function; Physical activity; Population; Problem Solving; Process; Public Health; Randomized; Recommendation; Recovery; Research; Schedule; Technology; Thermogenesis; Time; Update; Work; base; comparison intervention; design; disability; exercise intervention; experience; frailty; functional decline; functional outcomes; high risk; improved; innovation; knee replacement arthroplasty; mHealth; novel; preference; programs; recruit; remote delivery; response; sedentary; sedentary lifestyle; smartphone Application; success; telephone coaching; theories; time use; vibration

Project Summary/Abstract The number of individuals undergoing total knee replacement (TKR) each year continues to rise. While TKR is effective for improving pain and function, subsequent improvements in physical activity are not common. As a result, patients spend most of their day engaged in sedentary behavior, which may put them at higher risk of experiencing poor function and disability, as well as lower the overall success of the surgical treatment. Intervening on sedentary time, rather than physical activity, may be a more feasible first-step approach for modifying activity-related behaviors in this population. Therefore, the purpose of this innovative clinical trial is to use TKR as a teachable moment for implementing a sedentary reduction intervention. We propose to use a just-in-time mobile health (mHealth) intervention to reduce sedentary time among TKR patients. Patients (n=92) scheduled for TKR will be recruited to participate prior to surgery and then randomized at 4 weeks after surgery to either (1) NEAT!2 or (2) Control. NEAT!2 participants will use the NEAT!2 (Non-Exercise Activity Thermogenesis version 2) smartphone app until 3 months after surgery. The NEAT!2 app is designed to provide a vibration and/or audible tone to interrupt prolonged bouts of sitting detected from the smartphone’s internal accelerometer. Further, NEAT!2 has been adapted based on TKA patient input and program preference. NEAT!2 participants will receive biweekly coaching calls between 4 and 12 weeks after surgery. Control participants will receive an education control app and receive non-intervention calls to assess general recovery. Both groups will receive monthly maintenance calls between 3 and 6 months. Data collection will occur pre-operatively, as well as at the end of treatment (3 months after TKR) and the maintenance assessment (6 months after TKR). The primary aim is to examine the effects of the NEAT!2 intervention on sedentary time at end of treatment (3 months) and maintenance (6 months). Secondary aims include examining the effects of the NEAT!2 intervention on physical function, physical activity, and pain as well as examining the dose response relationship between adherence to NEAT!2 and changes in outcomes. The proposed study will examine the innovative approach of decreasing sedentary time prior to targeting physical activity in adults after TKR and determine if a remotely-delivered, mHealth sedentary reduction intervention can decrease sedentary time. The study is innovative for integrating a just-in-time technology-based approach to reduce sedentary time during a “teachable moment” for TKR patients. The results of this study will build on our previous and current work to improve health behaviors after TKA and help to identify potentially effective and scalable strategies to improve long-term physical activity behaviors and physical function in patients after TKR.

项目摘要/摘要 每年接受全膝关节置换术(TKR)的人数持续上升。而当 TKR对改善疼痛和功能是有效的，但随后的体力活动改善则不是 很普通。因此，患者一天中的大部分时间都在从事久坐不动的行为，这可能会使他们处于 较高的功能不良和残疾风险，以及较低的手术总体成功率 治疗。干预久坐时间，而不是体力活动，可能是更可行的第一步 在这一群体中修改与活动相关的行为的方法。因此，这一创新的目的 临床试验是利用TKR作为实施久坐减少干预的可教时刻。 我们建议使用即时移动健康(MHealth)干预来减少以下人群的久坐时间 TKR患者。计划接受TKR的患者(n=92)将在手术前被招募参加，然后 术后4周随机分为(1)纯2组或(2)对照组。整齐！2名参与者将使用 Neat！2(非运动活动生热版本2)智能手机应用程序，直到手术后3个月。这个 Neat！2应用程序旨在提供振动和/或声音音调，以中断长时间的坐着 从智能手机的内部加速度计检测到。此外，Neat！2还根据TKA进行了改编 患者输入和程序偏好。整齐！2名参与者将收到两周一次的辅导电话，时间为4至4周 术后12周。控制参与者将收到一个教育控制应用程序，并获得不干预 要求评估总体复苏的呼声。这两个小组每月都会接到3到6个维护电话 月份。数据收集将在手术前和治疗结束时(TKR后3个月)和 维修评估(TKR后6个月)。主要目的是检查整洁的效果！2 治疗结束(3个月)和维持期(6个月)对久坐时间的干预。次要目标 包括检查整齐2干预对身体机能、身体活动和疼痛的影响 以及检查坚持使用Net！2和结果变化之间的剂量反应关系。 这项拟议的研究将考察减少久坐时间的创新方法 针对成人TKR后的体力活动，并确定远程递送的mHealth久坐 减少干预可以减少久坐时间。这项研究在整合Just-In-Time 以技术为基础的方法，减少TKR患者在“可教时刻”的久坐时间。这个 这项研究的结果将建立在我们以前和现在改善TKA后健康行为的工作基础上，并有助于 确定潜在有效和可扩展的策略，以改善长期的体力活动行为和 TKR术后患者的身体功能。