PHYSICAL ACTIVITY MANAGEMENT FOR CLIENTS WITH ARTHRITIS-PILOT STUDY

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 关节炎是成年人残疾的主要原因。 在美国近7000万关节炎患者中，有700多万成年人是残疾人。 膝关节骨性关节炎（OA）和关节炎是成年人残疾的主要原因。 在美国近7000万关节炎患者中，有700多万成年人是残疾人。 膝骨关节炎（OA）和类风湿性关节炎（RA）是两种最常见和致残的关节炎。 美国人口中从事推荐的体力活动量的比例很低，关节炎患者的比例更低。 此外，临床医生对关节炎患者体力活动的促进存在相当大的差异。 本研究项目的目的是评估一个可导出的实践为基础的身体活动促进计划适用于关节炎患者相比，通常的医生咨询的有效性。 身体活动促进计划包括关节炎综合治疗评估（ACTA），该评估确定了参与身体活动的障碍，以及以客户为中心的个性化目标设定，治疗计划和习惯养成干预计划。 本研究将受试者随机分配至医师咨询组（第1组）或医师咨询的体力活动促进计划组（第2组）。 在这两组中，重点是增加参与者对生活方式体育活动的参与，即，日常活动如家务、以步行代替驾驶、娱乐活动如游泳和跳舞等，而不是传统的正式运动。 所有参与者将佩戴加速计（测量身体运动）7天，回答有关身体功能、生活质量、身体活动、动机、目标、药物使用和人口统计信息的电话采访，并进行两次功能状态的观察测量。 将在基线访视后3、6、12、18和24个月重复进行该系列评估（观察到的身体功能检查除外，仅在12和24个月时重复进行）。 第1组将在基线访视时接受医生咨询，然后在定期安排的诊所访视时接受医生咨询。 第2组将在基线时接受医生咨询和体力活动促进计划，每3个月进行一次ACTA评估，并在必要时与体力活动倡导者举行进一步的干预会议，并由参与者和倡导者同意。 本随机对照试验的具体目的是： 1.测试与医生体力活动咨询相结合的体力活动促进计划（第2组）与仅医生咨询（第1组）相比在改善关节炎特异性和一般健康相关生活质量方面的有效性， 2.测试身体活动促进计划与医生咨询干预在改善功能和心脏健康的观察指标方面的有效性 3.测试身体活动促进计划与医生咨询干预在改善身体活动表现方面的有效性。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Arthritis is a major cause of disability among adults. Of the nearly 70 million persons in the US with arthritis, more than 7 million adults are disabled. Knee osteoarthritis (OA) and Arthritis is a major cause of disability among adults. Of the nearly 70 million persons in the US with arthritis, more than 7 million adults are disabled. Knee osteoarthritis (OA) and Rheumatoid Arthritis (RA) are two of the most common and disabling forms of arthritis. The proportion of the US population who engage in the recommended amount of physical activity is low and even lower among those with arthritis. Moreover, there is considerable variation among clinicians' promotion of physical activity in arthritis patients. The objective of this research project is to evaluate the effectiveness of an exportable practice-based Physical Activity Promotion program applicable to patients with arthritis compared to usual physician counseling. The Physical Activity Promotion Program consists of the Arthritis Comprehensive Treatment Assessment (ACTA) that identifies barriers to participation in physical activity and a client-centered, individualized goal setting, treatment planning, and habit acquisition intervention program. This study will randomize participants to either Physician Counseling (Group 1) or to the Physical Activity Promotion Program with Physician Counseling (Group 2). In both groups, the focus is on increasing participant's participation in lifestyle physical activity, i.e., everyday activities such as housework, walking instead of driving, recreational activities such as swimming and dancing, etc. rather than on traditional formal exercise. All participants will wear an accelerometer (measures physical movement) for seven days, respond to a telephone interview about physical function, quality of life, physical activity, motivation, goals, medication use, and demo-graphic information, and carry out two observed measures of functional status. This series of assessments will be repeated at 3, 6, 12, 18, and 24 months after the baseline visit (except for the observed physical function tests which will be repeated at 12 and 24 months only). Group 1 will receive Physician Counseling at the baseline visit and then at their regularly scheduled clinic visits. Group 2 will receive Physician Counseling and the Physical Activity Promotion Program at baseline, the ACTA assessment at 3 monthly intervals and further intervention meetings with the Physical Activity Advocate as necessary and agreed upon by the Participant and Advocate. The specific aims of this randomized, controlled trial are to: 1. Test the effectiveness of the Physical Activity Promotion Program combined with Physician physical activity counseling (Group 2) compared to Physician Counseling only (Group 1) in im-proving arthritis-specific and generic health-related quality of life, 2. Test the effectiveness of the Physical Activity Promotion Program vs. Physician Counseling intervention in improving observed measures of function and cardiac fitness 3. Test the effectiveness of the Physical Activity Promotion Program vs. Physician Counseling intervention in improving physical activity performance.