Promoting maintenance of physical activity in older knee osteoarthritis patients

描述(申请人提供)：膝骨性关节炎(OA)是一种慢性退行性疾病，影响大约三分之一的美国老年人。随着膝骨性关节炎的进展，关节损伤和慢性疼痛损害了生活质量和身体功能，并促进了老年人身体残疾的发生。来自几个随机对照试验的证据表明，体育活动干预显著改善了膝骨性关节炎老年患者的身体功能和生活质量。尽管运动有好处，但在老年膝骨性关节炎患者中促进长期保持体力活动参与仍然是有问题的。结构性体力活动干预的过度消耗的一个潜在解释是，传统的运动治疗方法无法提供足够的自我调节技能的指导或练习，这些技能是保持独立、长期参与所必需的。因此，本研究的主要目的是确定与传统的体力活动干预相比，在3个月和12个月的随访评估中，包括个体化和基于群体的活动咨询的群体中介认知行为(GMCB)体力活动干预是否会导致每周中等强度或更大体力活动(PARMod+)的频率和数量更高。GMCB干预计划结合了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，促进保持独立的身体活动参与，同时在最初的3个月内逐步取消以中心为基础的活动。我们的假设是，与传统的体力活动计划相比，GMCB干预计划在3个月和12个月末将产生显著更高的PARMod+参与频率和数量。调查的次要目的是确定GMCB和传统体育活动干预对自我报告的身体功能和疼痛、活动能力和与健康相关的生活质量的影响。 公共卫生相关声明：这项拟议的调查审查了行为干预的有效性，以促进长期保持定期体力活动，并增强患有膝骨性关节炎的老年人的疾病症状。鉴于骨性关节炎是影响美国老年人的最常见疾病之一，被认为是随着年龄的增长而导致残疾的主要原因之一，该应用程序解决了一个重要的公共卫生问题，随着美国人口老龄化的继续加剧，这个问题的规模只会越来越大。

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.