Reducing Sedentary Time Using an Innovative mHealth Intervention Among Total Knee Replacement Patients

使用创新的移动医疗干预措施减少全膝关节置换患者的久坐时间

• 批准号: 10132987
• 负责人: Christine Ann Pellegrini
• 金额: $ 15.28万
• 依托单位: UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-01 至 2023-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10132987
• 关键词: Accelerometer; Accounting; Adherence; Adult; Behavior; Cellular Phone; Clinical Trials; Control Groups; Data; Data Collection; Dose; Education; Face; General Population; Goals; Health Care Costs; Health behavior; Impairment; Individual; Interruption; Intervention; Knee Osteoarthritis; Lead; Light; Light Exercise; Maintenance; Measures; Monitor; Motivation; Non-Insulin-Dependent Diabetes Mellitus; Operative Surgical Procedures; Outcome; Outcome Study; Pain; Participant; Patients; Physical Function; Physical activity; Population; Problem Solving; Process; Public Health; Randomized; Recommendation; Recovery; Research; Schedule; Technology; Thermogenesis; Time; Update; Work; base; comparison intervention; design; disability; exercise intervention; experience; frailty; functional decline; functional outcomes; high risk; improved; innovation; knee replacement arthroplasty; mHealth; novel; preference; programs; recruit; remote delivery; response; sedentary; sedentary lifestyle; smartphone Application; success; telephone coaching; theories; time use; vibration

Project Summary/Abstract The number of individuals undergoing total knee replacement (TKR) each year continues to rise. While TKR is effective for improving pain and function, subsequent improvements in physical activity are not common. As a result, patients spend most of their day engaged in sedentary behavior, which may put them at higher risk of experiencing poor function and disability, as well as lower the overall success of the surgical treatment. Intervening on sedentary time, rather than physical activity, may be a more feasible first-step approach for modifying activity-related behaviors in this population. Therefore, the purpose of this innovative clinical trial is to use TKR as a teachable moment for implementing a sedentary reduction intervention. We propose to use a just-in-time mobile health (mHealth) intervention to reduce sedentary time among TKR patients. Patients (n=92) scheduled for TKR will be recruited to participate prior to surgery and then randomized at 4 weeks after surgery to either (1) NEAT!2 or (2) Control. NEAT!2 participants will use the NEAT!2 (Non-Exercise Activity Thermogenesis version 2) smartphone app until 3 months after surgery. The NEAT!2 app is designed to provide a vibration and/or audible tone to interrupt prolonged bouts of sitting detected from the smartphone’s internal accelerometer. Further, NEAT!2 has been adapted based on TKA patient input and program preference. NEAT!2 participants will receive biweekly coaching calls between 4 and 12 weeks after surgery. Control participants will receive an education control app and receive non-intervention calls to assess general recovery. Both groups will receive monthly maintenance calls between 3 and 6 months. Data collection will occur pre-operatively, as well as at the end of treatment (3 months after TKR) and the maintenance assessment (6 months after TKR). The primary aim is to examine the effects of the NEAT!2 intervention on sedentary time at end of treatment (3 months) and maintenance (6 months). Secondary aims include examining the effects of the NEAT!2 intervention on physical function, physical activity, and pain as well as examining the dose response relationship between adherence to NEAT!2 and changes in outcomes. The proposed study will examine the innovative approach of decreasing sedentary time prior to targeting physical activity in adults after TKR and determine if a remotely-delivered, mHealth sedentary reduction intervention can decrease sedentary time. The study is innovative for integrating a just-in-time technology-based approach to reduce sedentary time during a “teachable moment” for TKR patients. The results of this study will build on our previous and current work to improve health behaviors after TKA and help to identify potentially effective and scalable strategies to improve long-term physical activity behaviors and physical function in patients after TKR.

项目摘要/摘要 每年经历了总膝盖置换（TKR）的人数继续增加 TKR可有效地改善疼痛和功能，随后的医学改善不是 因此，患者大部分时间都在英语 较高的功能和残疾的风险较高，并降低了手术的整体成功。 处理第二个补充时间，而不是体育锻炼 在此人群中修改与活动相关的行为的方法。 临床试验是将TKR用作实施久坐的减少干预措施的可教学时刻。 我们建议使用及时的移动健康（MHealth）干预措施，以减少在 TKR患者（n = 92）计划在手术前招募 在手术后4周将（1）整洁的人（2）使用。 Neat！ 整洁！2应用程序旨在提供振动和/或听觉的音调 从智能手机的内部加速度计中检测到。 患者的投入和计划偏好。 手术后12周。 评估一般恢复的电话。 数据收集将在术前发生 维护评估（TKR后6个月） 治疗结束时久坐时间（3个月）和维护时间（6个月） 包括检查整洁的影响！ 以及研究遵守整洁的剂量响应关系！ 支撑研究将研究减少久坐时间之前的创新方法 靶向TKR后成人的体育锻炼，并确定是否已延期，MHealth久经考验 减少间隔可以减少久坐的时间。 基于技术的方法，可以在TKR患者的“可教时间”中引诱时间 这项研究的结果是基于我们在TKA之后改善健康行为的目前和目前的工作的基础 确定潜在的有效且可扩展的策略，以改善长期体育锻炼行为和 患者的身体机能。