Physical Activity Interventions for Leg Ulcer Patients

 描述(申请人提供)：移动健康(MHealth)技术可以帮助个人采取健康的生活方式行为，特别是在体力活动(PA)中，用于治疗和自我管理慢性病。随着以患者为中心的护理与新兴的以患者为中心的技术相融合，存在着促进有效的患者与提供者沟通的需求。这对于行动不便、患有慢性病的人群尤其重要。我们建议FOOTFIT，一种新的小腿调理mHealth干预措施，用于治疗静脉性小腿溃疡患者。我们的目标是比较两个版本，其中一个是增强型(FOOTFIT)，以确定哪个版本对PA依从性、患者与提供者的沟通和腿部功能影响最大。FOOTFIT和FOOTFIT共享三个组件：1)低成本、支持三轴蓝牙(R)的高灵敏度加速度计和跟踪设备(BEAT)，可在运动过程中佩戴在脚上；2)通过智能手机跟踪小腿功能(小腿)的阶段性调节活动；3)智能手机捕获BEAT信号，提供激励信息、小腿指导和自动进度反馈。FOOTFIT增加了一个组件，通过智能手机的互联网连接促进患者与提供者的沟通。我们将这种PA干预设计为对接受PA计划的机会有限的最小活动患者严重解除条件的小腿进行调理的第一步。据我们所知，连接加速计和患者-提供者通信以检查腿部溃疡人群对PA的依从性的系统尚未经过测试。这种干预的两个重要特征值得注意。首先，基于脚的加速测量法(例如Fitbit(R))被很好地记录下来，用于捕捉移动的、更健康的人群的活动和能量消耗。由我们的研究团队开发和测试，我们基于脚的有效和可靠的节拍强调捕捉不太剧烈的活动(例如脚趾和脚的运动)，这通常是这些条件不佳的患者一次最多只能走几步的最大强度。其次，这项研究将测试作为FOOTFIT的一部分建立患者-提供者通信链路的可行性和可接受性。这些患者将可以通过智能手机(电子邮件、短信、直拨电话)与提供者联系，并将从提供者那里接收自动化和个性化的励志信息和基于理论的口头交流。我们试图发现腿部溃疡患者是否按照建议使用FOOTFIT系统，以及它是否增加了对PA的依从性，促进了患者和提供者之间的沟通，减少了身体痛苦症状，并增强了下肢功能能力。我们相信FOOTFIT将促进围绕患者进展反馈的更及时、更有效的患者-提供者沟通。我们将评估这将如何在现实世界中发挥作用 它可能会放在忙碌的供应商身上。在这项为期六周的研究中，40名患者将成为目标，其中20名患者将接受FOOTFIT治疗，20名患者将接受FOOTFIT治疗。

 DESCRIPTION (provided by applicant): Mobile Health (mHealth) technology can help individuals adopt healthy lifestyle behaviors, particularly in physical activity (PA) for the treatment and self-management of chronic diseases. As patient centered care melds with emerging patient centered technology, a need exists to promote effective patient-provider communication. This is especially important for minimally ambulatory, chronically ill populations. We propose FOOTFIT, a novel lower leg conditioning mHealth intervention for patients with venous leg ulcers. We aim to compare two versions, one of which is enhanced (FOOTFIT+), to determine which has the greatest impact on PA adherence, patient-provider communication, and leg function. FOOTFIT and FOOTFIT+ share three components: 1) a low-cost, tri-axial Bluetooth(r) enabled highly sensitive accelerometer and tracking device (BEAT) worn on the foot during, 2) phased conditioning activities for lower leg function (CALF) tracked by a, 3) Smartphone that captures signals from BEAT, provides motivational messages, CALF instruction, and automated feedback on progress. FOOTFIT+ has the added component that promotes patient-provider communication through Internet connectivity via the Smartphone. We designed this PA intervention as an initial step in conditioning severely deconditioned lower legs of minimally ambulatory patients who have limited access to PA programs. To our knowledge, a system that connects accelerometers and patient-provider communication to examine adherence to PA in leg ulcer populations has not been tested. Two important features of this intervention are worth noting. First, foot-based accelerometry (e.g. Fitbit(r)) is well documented for the capture of activity and energy expenditure in mobile, healthier populations. Developed and tested by our study team, our valid and reliable foot-based BEAT emphasizes the capture of less intense activity (e.g. toe and foot movements) that is often the maximum intensities displayed by these deconditioned patients who can at best only take a few steps at a time. Secondly, the study will test the feasibility and acceptability of having a patient-provider communication link as part of FOOTFIT+. These patients will have access to the provider via the Smartphone (email, text, direct calling), and will receive automated and personalized, motivational messages and theory-based verbal exchanges from the provider. We seek to discover whether patients with leg ulcers use the FOOTFIT system as recommended and if it increases adherence to PA, promotes communication between patients and providers, reduces physically distressing symptoms, and enhances lower extremity functional abilities. We believe FOOTFIT+ will facilitate more timely and effective patient-provider communication around feedback on patient progress. We will evaluate how this will work in the real world with the strain that it might place on busy providers. Forty patients will be targeted in this six-week study, 20 o which will receive FOOTFIT and 20 FOOTFIT+.