Mind Your Walk Intervention for Community-Based Management of Knee OA: A Feasibility Study

以社区为基础的膝骨关节炎管理的步行干预：可行性研究

• 批准号: 10006121
• 负责人: Deepak Kumar
• 金额: $ 12.45万
• 依托单位: BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-06 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10006121
• 关键词: Accelerometer; Adherence; Adult; Affect; Age; Attention; Award; Awareness; Biomechanics; Biometry; Cartilage; Cessation of life; Clinical; Clinical Trials; Clinical Trials Design; Collection; Communities; Control Groups; Country; Data; Degenerative polyarthritis; Devices; Diagnostic radiologic examination; Disease; Dyskinetic syndrome; Education; Elderly; Exercise; Failure; Feasibility Studies; Feedback; Future; Goals; Health; Health Technology; Home environment; Individual; Intervention; Joints; Knee; Knee Osteoarthritis; Knee joint; Knowledge; Lead; Leadership; Mentors; Methods; Mind; Mobile Health Application; Modeling; Monitor; Motion; Movement; Muscle; Musculoskeletal; Older Population; Ontario; Outcome; Pain; Paper; Pathway interactions; Patient Outcomes Assessments; Patient Self-Report; Patients; Pattern; Persons; Physical activity; Population; Positioning Attribute; Principal Investigator; Process; Public Health; Quality of life; Randomized; Rehabilitation therapy; Reporting; Research; Research Personnel; Resources; Rheumatology; Risk; Running; Science; Senior Scientist; Source; Structure; Techniques; Technology; Testing; Time; Training; Translating; Treatment Efficacy; Walking; Western Ontario and McMaster Universities Arthritis Index; arm; base; community intervention; comparative efficacy; comparison intervention; cost; design; diaries; disability; effective intervention; efficacy trial; exercise program; experience; field study; functional outcomes; gait examination; gait rehabilitation; high risk; improved; indexing; innovation; mHealth; mindfulness; mobile computing; mortality; patient oriented; pressure; primary outcome; programs; quantitative imaging; randomized trial; recruit; screening; sedentary; skills; slow potential; standard of care; successful intervention; therapy design; tool; trial design; usability; walking intervention; walking program

PROJECT SUMMARY/ ABSTRACT: The overarching goal of this research is to develop an effective walking- based intervention that reduces disability and also maintains joint structure for people with knee osteoarthritis (OA). Walking disability leads to an increased risk of early death in people with knee OA. Furthermore, people with knee OA walk with movement patterns that overload the cartilage and may lead to rapid OA progression. Current gait retraining interventions use expensive devices, target a single joint, or focus on only reducing the knee adduction moment. Furthermore, these interventions may not address adherence, dissemination, and scalability, and may not utilize the ubiquity of mobile technology. This project proposed to demonstrate the feasibility of an innovative community based intervention (“Mind Your Walk”) that incorporates whole-body movement retraining based on biomechanical principles, along with mindful body-awareness skills, for people with knee OA. The goal is to use the results from this project to support the design of a larger randomized trial comparing this intervention with standard exercise programs. To achieve this goal, this project will focus on - 1) demonstrating feasibility of recruitment, adherence, and retention with the Mind Your Walk intervention, 2) quantifying the variability of biomechanical and functional outcomes, and 3) usability testing of a mobile health (mHealth) application for monitoring adherence and maintaining engagement for Mind Your Walk intervention. Subjects with radiographic and symptomatic knee OA (n=62) will participate in the feasibility study. Another group (n=10) will participate in usability testing of the mHealth application. The intervention will be delivered using community-based group sessions over 6-months. After that the subjects will practice on their own for another 6-months. The attention-matched control group will receive education on OA. In addition to feasibility data, knee loading during walking will be quantified using an EMG-Driven knee model and gait analyses at baseline and 6-months. Daily physical activity using accelerometers and self-reported pain will be recorded at baseline and every 3-months for a period of 1-year. The principal investigator (PI) has expertise in rehabilitation, biomechanics, and applications of quantitative imaging. The PI's long-term goal is to lead an inter-disciplinary translational musculoskeletal research program in OA; that is focused on unraveling the biomechanical pathways underlying OA, and using this knowledge to develop targeted interventions. This award will enable the applicant to gain additional training in all aspects of clinical trials and use of mHealth technologies in knee OA. Additional training will focus on advanced biostatistics for clinical trials and longitudinal data, and on leadership and team science. The mentoring team comprises of established senior scientists in rheumatology, clinical trials, mobile health technologies, and biostatistics. The PI has strong Institutional support, and this project will accelerate the PI's transition to an independent investigator, and enable collection of critical data for design of the clinical trial.

项目摘要/摘要：这项研究的首要目标是开发一种有效的步行- 为膝骨性关节炎患者减少残疾并维持关节结构的基于干预 (办公自动化)。行走障碍会增加膝骨性关节炎患者过早死亡的风险。此外，人们 对于膝骨性关节炎，步行时的运动模式会使软骨过载，并可能导致膝骨性关节炎的快速进展。 目前的步态再训练干预措施使用昂贵的设备，针对单个关节，或仅专注于减少 膝关节内收瞬间。此外，这些干预措施可能不涉及遵守、传播和 可伸缩性，可能无法利用移动技术的无处不在。该项目旨在演示 以社区为基础的创新干预(“注意你的走路”)结合全身的可行性 基于生物力学原理的运动再训练，以及专注的身体意识技能 膝盖骨关节炎。目标是利用这个项目的结果来支持更大规模的随机试验的设计 将这种干预与标准运动计划进行比较。为了实现这一目标，本项目将重点放在-1) 展示招募、坚持和留住思维的可行性，2) 量化生物力学和功能结果的可变性，以及3)移动健康的可用性测试 (MHealth)应用程序，用于监控您的步行干预的遵从性和保持参与度。 62名患有放射学和症状性膝骨性关节炎的受试者将参与可行性研究。另一个 小组(n=10)将参与mHealth应用程序的可用性测试。干预措施将会实施 使用基于社区的小组会议，为期6个月。在那之后，受试者将自己练习 再过6个月。注意匹配的对照组将接受有关OA的教育。除了可行性之外 数据，步行过程中的膝关节负荷将使用EMG驱动的膝关节模型和步态分析进行量化 基线和6个月。使用加速计的日常体力活动和自我报告的疼痛将被记录在 基准线和每3个月，为期1年。 首席调查员(PI)在康复、生物力学和应用 定量成像。PI的长期目标是领导一个跨学科的翻译肌肉骨骼 骨性关节炎的研究计划；专注于解开骨性关节炎的生物力学途径，并使用 这一知识有助于制定有针对性的干预措施。这项奖励将使申请人能够获得额外的培训。 在膝盖骨关节炎的临床试验和使用mHealth技术的方方面面。额外的培训将集中在 临床试验和纵向数据的高级生物统计学，以及领导力和团队科学。指导工作 团队由风湿学、临床试验、移动健康技术和 生物统计学。PI有强大的制度支持，该项目将加速PI向 独立的研究人员，并能够收集临床试验设计的关键数据。