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: 10132987
• 负责人: Christine Ann Pellegrini
• 金额: $ 15.28万
• 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 2023-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10132987
• 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.

项目概要/摘要 每年接受全膝关节置换术（TKR）的人数持续增加。尽管 TKR 可有效改善疼痛和功能，但随后的身体活动改善效果不佳 常见的。因此，患者一天中的大部分时间都处于久坐行为，这可能使他们处于 出现功能不良和残疾的风险较高，并且手术的总体成功率较低 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 改变该人群活动相关行为的方法。因此，本次创新的目的是 临床试验的目的是使用 TKR 作为实施减少久坐干预措施的教学时刻。 我们建议使用即时移动健康（mHealth）干预措施来减少人们的久坐时间 TKR 患者。计划进行 TKR 的患者 (n=92) 将被招募在手术前参与，然后 术后 4 周随机分为 (1) NEAT!2 或 (2) 对照。 NEAT!2 参与者将使用 NEAT!2（非运动活动产热版本 2）智能手机应用程序直至手术后 3 个月。这 NEAT!2 应用程序旨在提供振动和/或声音来打断长时间坐着 从智能手机的内部加速度计检测到。此外，NEAT!2基于TKA进行了改编 患者的意见和方案偏好。 NEAT!2 参与者将在 4 点到 4 点之间每两周收到一次辅导电话 手术后12周。控制参与者将收到教育控制应用程序并接受不干预 呼吁评估总体复苏情况。两组都会在每月 3 点到 6 点之间接到维护电话 几个月。数据收集将在术前以及治疗结束时（TKR 后 3 个月）进行 维持评估（TKR 后 6 个月）。主要目的是检查 NEAT!2 的效果 在治疗结束（3个月）和维持治疗（6个月）时对静坐时间进行干预。次要目标 包括检查 NEAT!2 干预对身体功能、身体活动和疼痛的影响 以及检查 NEAT!2 依从性与结果变化之间的剂量反应关系。 拟议的研究将探讨减少久坐时间的创新方法 针对 TKR 后成人的体力活动，并确定远程传输的 mHealth 久坐不动 减少干预可以减少久坐时间。这项研究对于整合即时 基于技术的方法，减少 TKR 患者“受教时刻”的久坐时间。这 这项研究的结果将建立在我们之前和当前的工作基础上，以改善 TKA 后的健康行为并帮助 确定潜在有效且可扩展的策略，以改善长期的身体活动行为，以及 TKR 后患者的身体功能。