Mind Your Walk Intervention for Community-Based Management of Knee OA: A Feasibility Study

以社区为基础的膝骨关节炎管理的步行干预：可行性研究

• 批准号: 10208716
• 负责人: Deepak Kumar
• 金额: $ 12.45万
• 依托单位: BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-06 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10208716
• 关键词: Accelerometer; Adherence; Adult; Affect; Age; Attention; Award; Awareness; Biomechanics; Biometry; Body mass index; Cartilage; Cessation of life; Clinical; Clinical Trials; Clinical Trials Design; Collection; Communities; Control Groups; Country; Data; Degenerative polyarthritis; Devices; Diagnostic radiologic examination; Disease; Dyskinetic syndrome; Education; Elderly; Exercise; Failure; Feasibility Studies; Feedback; Future; Goals; Health; Health Technology; Home; Individual; Intervention; Joints; Knee; Knee Osteoarthritis; Knee joint; Knowledge; Lead; Leadership; Mentors; Methods; Mind; Mobile Health Application; Modeling; Monitor; Motion; Movement; Muscle; Musculoskeletal; Older Population; Ontario; Outcome; Pain; Paper; Pathway interactions; Patient Outcomes Assessments; Patient Self-Report; Patients; Pattern; Persons; Physical activity; Population; Positioning Attribute; Principal Investigator; Process; Public Health; Quality of life; Randomized; Rehabilitation therapy; Reporting; Research; Research Personnel; Resources; Rheumatology; Risk; Running; Science; Senior Scientist; Source; Structure; Techniques; Technology; Testing; Time; Training; Translating; Treatment Efficacy; Walking; Western Ontario and McMaster Universities Arthritis Index; arm; base; community intervention; comparative efficacy; comparison intervention; cost; design; diaries; disability; disability risk; efficacy trial; exercise program; experience; feasibility testing; field study; functional outcomes; gait examination; gait rehabilitation; high risk; improved; indexing; innovation; mHealth; mindfulness; mobile computing; mortality; patient oriented; pressure; primary outcome; programs; quantitative imaging; randomized trial; recruit; screening; sedentary; skills; slow potential; standard of care; therapy design; tool; trial design; usability; walking intervention; walking program

PROJECT SUMMARY/ ABSTRACT: The overarching goal of this research is to develop an effective walking- based intervention that reduces disability and also maintains joint structure for people with knee osteoarthritis (OA). Walking disability leads to an increased risk of early death in people with knee OA. Furthermore, people with knee OA walk with movement patterns that overload the cartilage and may lead to rapid OA progression. Current gait retraining interventions use expensive devices, target a single joint, or focus on only reducing the knee adduction moment. Furthermore, these interventions may not address adherence, dissemination, and scalability, and may not utilize the ubiquity of mobile technology. This project proposed to demonstrate the feasibility of an innovative community based intervention (“Mind Your Walk”) that incorporates whole-body movement retraining based on biomechanical principles, along with mindful body-awareness skills, for people with knee OA. The goal is to use the results from this project to support the design of a larger randomized trial comparing this intervention with standard exercise programs. To achieve this goal, this project will focus on - 1) demonstrating feasibility of recruitment, adherence, and retention with the Mind Your Walk intervention, 2) quantifying the variability of biomechanical and functional outcomes, and 3) usability testing of a mobile health (mHealth) application for monitoring adherence and maintaining engagement for Mind Your Walk intervention. Subjects with radiographic and symptomatic knee OA (n=62) will participate in the feasibility study. Another group (n=10) will participate in usability testing of the mHealth application. The intervention will be delivered using community-based group sessions over 6-months. After that the subjects will practice on their own for another 6-months. The attention-matched control group will receive education on OA. In addition to feasibility data, knee loading during walking will be quantified using an EMG-Driven knee model and gait analyses at baseline and 6-months. Daily physical activity using accelerometers and self-reported pain will be recorded at baseline and every 3-months for a period of 1-year. The principal investigator (PI) has expertise in rehabilitation, biomechanics, and applications of quantitative imaging. The PI's long-term goal is to lead an inter-disciplinary translational musculoskeletal research program in OA; that is focused on unraveling the biomechanical pathways underlying OA, and using this knowledge to develop targeted interventions. This award will enable the applicant to gain additional training in all aspects of clinical trials and use of mHealth technologies in knee OA. Additional training will focus on advanced biostatistics for clinical trials and longitudinal data, and on leadership and team science. The mentoring team comprises of established senior scientists in rheumatology, clinical trials, mobile health technologies, and biostatistics. The PI has strong Institutional support, and this project will accelerate the PI's transition to an independent investigator, and enable collection of critical data for design of the clinical trial.

项目摘要/摘要：这项研究的总体目标是开发一种有效的步行方法 基于干预措施，可减少膝骨关节炎患者的残疾并维持关节结构 (OA) 步行障碍会导致膝关节骨关节炎患者过早死亡的风险增加。 膝骨关节炎患者行走时的运动模式会使软骨超载，并可能导致骨关节炎快速进展。 目前的步态再训练干预措施使用昂贵的设备，针对单个关节，或者只专注于减少 此外，这些干预措施可能无法解决依从性、传播和运动的问题。 可扩展性，并且可能不会利用无处不在的移动技术。 基于社区的创新干预措施（“Mind Your Walk”）的可行性，该干预措施结合了全身 基于生物力学原理以及正念身体意识技能的运动再训练 目标是利用该项目的结果来支持更大规模的随机试验的设计。 为了实现这一目标，该项目将重点关注 - 1) 展示“Mind Your Walk”干预措施招募、坚持和保留的可行性，2) 量化生物力学和功能结果的变异性，以及 3) 移动健康的可用性测试 (mHealth) 应用程序，用于监测遵守情况并保持对“注意步行”干预的参与。 患有放射学和症状性膝关节 OA 的受试者 (n=62) 将参加另一个可行性研究。 小组（n=10）将参与移动医疗应用程序的可用性测试。 使用为期 6 个月的基于社区的小组课程，之后受试者将自行练习。 另外 6 个月，关注匹配的对照组将接受关于 OA 的教育。 数据，步行期间的膝盖负荷将使用肌电图驱动的膝盖模型和步态分析进行量化 使用加速度计记录基线和 6 个月的每日身体活动以及自我报告的疼痛。 基线和 1 年期间每 3 个月一次。 首席研究员 (PI) 拥有康复、生物力学和应用方面的专业知识 PI 的长期目标是领导跨学科的转化肌肉骨骼领域。 OA 研究计划；重点是揭示 OA 的生物力学途径，并利用 该奖项将使申请人能够获得额外的培训。 临床试验的各个方面以及移动医疗技术在膝关节 OA 中的应用 额外的培训将重点关注。 用于临床试验和纵向数据以及领导力和团队科学的高级生物统计学。 团队由风湿病学、临床试验、移动医疗技术等领域的资深科学家组成 PI 拥有强大的机构支持，该项目将加速 PI 向生物统计学的转变。 独立研究者，并能够收集临床试验设计的关键数据。

项目成果

Association of Quadriceps Adiposity With an Increase in Knee Cartilage, Meniscus, or Bone Marrow Lesions Over Three Years.

• DOI: 10.1002/acr.24232
• 发表时间: 2021-08
• 期刊: Arthritis care & research
• 影响因子: 4.7
• 作者: Kumar D;Link TM;Jafarzadeh SR;LaValley MP;Majumdar S;Souza RB
• 通讯作者: Souza RB

Interrelations between factors related to physical activity in inactive adults with knee pain.

• DOI: 10.1080/09638288.2021.1891303
• 发表时间: 2022-07
• 期刊: Disability and rehabilitation
• 影响因子: 2.2
• 作者: Shah N;Kramer J;Borrelli B;Kumar D
• 通讯作者: Kumar D

Association of Physical Therapy Interventions With Long-term Opioid Use After Total Knee Replacement.

• DOI: 10.1001/jamanetworkopen.2021.31271
• 发表时间: 2021-10-01
• 期刊: JAMA network open
• 影响因子: 13.8
• 作者: Aoyagi K;Neogi T;Peloquin C;Dubreuil M;Marinko L;Camarinos J;Felson DT;Kumar D
• 通讯作者: Kumar D

Delayed timing of physical therapy initiation increases the risk of future opioid use in individuals with knee osteoarthritis: a real-world cohort study.

物理治疗开始时间的延迟会增加膝骨关节炎患者未来使用阿片类药物的风险：一项现实世界的队列研究。

• DOI: 10.1136/bjsports-2022-106044
• 发表时间: 2023
• 期刊: British journal of sports medicine
• 影响因子: 18.4
• 作者: Kumar,Deepak;Neogi,Tuhina;Peloquin,Christine;Marinko,Lee;Camarinos,James;Aoyagi,Kosaku;Felson,DavidT;Dubreuil,Maureen
• 通讯作者: Dubreuil,Maureen

Impact of COVID-19 Pandemic on Physical Activity, Pain, Mood, and Sleep in Adults with Knee Osteoarthritis.

COVID-19 大流行对膝骨关节炎成人的体力活动、疼痛、情绪和睡眠的影响。

• DOI: 10.1123/jmpb.2022-0019
• 发表时间: 2022
• 期刊: Journal for the measurement of physical behaviour
• 作者: Rose,MichaelJ;LaValley,MichaelP;Jafarzadeh,SReza;Costello,KerryE;Shah,Nirali;Lee,Soyoung;Borrelli,Belinda;Messier,StephenP;Neogi,Tuhina;Kumar,Deepak
• 通讯作者: Kumar,Deepak