Promoting maintenance of physical activity in older knee osteoarthritis patients

描述（由申请人提供）：膝关节骨关节炎（OA）是一种慢性退行性疾病，影响美国大约三分之一的老年人。伴随膝关节炎进展的关节损伤和慢性疼痛损害了老年人的生活质量和身体功能，并促进了身体残疾的发生。来自几个随机对照试验的证据表明，体育活动干预可以显著改善老年膝关节OA患者的身体功能和生活质量。尽管运动有好处，但促进老年膝关节OA患者长期保持体育活动参与仍然存在问题。对于有组织的体育活动干预造成的过度损耗，一种可能的解释是，传统的运动治疗方法未能提供足够的指导或实践，以保持独立、长期参与所必需的自我调节技能。因此，本研究的主要目的是确定在3个月和12个月的随访评估中，与传统的身体活动干预相比，群体介导的认知行为（GMCB）身体活动干预，包括个性化和基于群体的活动咨询，是否会导致更高的每周中等强度或更大的身体活动频率和量（PARMod+）。GMCB干预项目包括团体和个人行为改变活动咨询，以帮助患者发展自我调节技能，促进维持独立的身体活动参与，同时在最初的3个月期间逐步停止以中心为基础的活动。我们的假设是，在3个月和12个月结束时，与传统的体育活动计划相比，GMCB干预计划将显著提高PARMod+参与的频率和数量。研究的次要目的是确定GMCB和传统体育活动干预对自我报告的身体功能和疼痛、活动表现和健康相关生活质量的影响。

DESCRIPTION (provided by applicant): Knee osteoarthritis (OA) is a chronic degenerative disease that affects approximately one third of all older adults in the United States. The joint damage and chronic pain accompanying the progression of knee OA compromises quality of life and physical function and facilitates the onset of physical disability in older adults. Evidence from several randomized controlled trials demonstrates that physical activity interventions result in significant improvements in physical function and quality of life among seniors with knee OA. Despite the benefits accompanying exercise, promoting long-term maintenance of physical activity participation among older knee OA patients remains problematic. One potential explanation for the excessive attrition from structured physical activity interventions is that traditional approaches to exercise therapy fail to provide adequate instruction or practice in the self-regulatory skills necessary to maintain independent, long-term participation. Therefore, the primary goal of this investigation is to determine if a group-mediated cognitive behavioral (GMCB) physical activity intervention involving individualized and group-based activity counseling will result in higher weekly frequency and volume of moderate intensity or greater physical activity (PARMod+) at 3 months and 12 month follow-up assessments when compared to a traditional physical activity intervention. The GMCB intervention program incorporates group and individual behavior change activity counseling to help patients develop self-regulatory skills that facilitate the maintenance of independent physical activity participation while concomitantly phasing out center-based activity over an initial 3-month period. It is our hypothesis that the GMCB intervention program will produce significantly higher frequency and volume of PARMod+ participation at the end of 3 and 12 months when compared to a traditional physical activity program. Secondary aims of the investigation are to determine the impact of the GMCB and traditional physical activity interventions on self-reported physical function and pain, mobility performance, and health-related quality of life. Public Health Relevance Statement: The proposed investigation examines the efficacy of behavioral interventions for promoting long-term maintenance of regular physical activity and enhancing disease symptoms in older adults with knee OA. Given that OA is one of the most prevalent diseases affecting older American and is considered one of the primary causes of disability with aging, the application addresses an important public health issue that will only grow in magnitude as the aging of the U.S. population continues to increase.