MONITOR-OA: Using Wearable Activity Trackers to Improve Physical Activity in Knee Osteoarthritis

Sponsor
University of British Columbia (Other)
Overall Status
Completed
CT.gov ID
NCT02315664
Collaborator
Simon Fraser University (Other), Arthritis Research Centre of Canada (Other), Vancouver General Hospital (Other)
61
1
2
18.7
3.3

Study Details

Study Description

Brief Summary

Physical activity is an essential first-line treatment for patients with knee osteoarthritis (OA). However, a 2013 systematic review found only 13% met the activity recommendation of 150 minutes or more per week. The primary goal of this randomized controlled trail is to assess the efficacy of a physical activity counseling model, involving a group education session, the use of Fitbit Flex (a wireless physical activity tracking device), and online/telephone coaching by a physiotherapist (PT), to improve physical activity and reduce sedentary time in patients with knee OA. Engaging in regular physical activity can have the additional benefit of improving cognitive functioning.

Condition or Disease Intervention/Treatment Phase
  • Behavioral: Education session, Fitbit Flex, and remote coaching by a PT
  • Behavioral: Same intervention with a 2 month delay
N/A

Detailed Description

This project will address the Research Question: Can a non-intrusive physical activity tracking tool, combined with a group education session and advice from a physiotherapist (PT), increase physical activity in patients with knee osteoarthritis (OA)? The investigators focus on knee OA because it is common (affecting 1 in 10) and can be debilitating. Being physically active improves pain, mobility and quality of life; however, less than half of patients are active. Combining the best evidence in OA care and digital technology, the investigators propose a new model of care for improving physical activity in patients with OA. Our primary objective is to determine whether a model involving 1) a group education session, 2) the use of Fitbit Flex, a commercially available physical activity tracker, and 3) remote coaching by a PT can improve physical activity and reduce sedentary time in patients with knee OA. This model of care is in line with the goal of Mary Pack Arthritis Program (MPAP) to optimize activity independence of OA patients with MPAP's available human resources. In this proof-of-concept randomized controlled trial (RCT), the investigators hypothesize that compared to a control group (i.e. the Delayed Intervention group), participants in the Immediate Intervention Group will 1) increase moderate/vigorous physical activity (MVPA), 2) reduce sedentary time, 3) improve in OA disease status, and 4) improve in their self-efficacy of OA management, 4) To examine whether individuals in the Intervention Group will show improved cognitive function over the intervention period compared to the control group, and 5) To examine the pre-intervention factors that predict the degree to which individuals in the Intervention Group increase MVPA and reduce sedentary time.

The investigators will use a mixed-methods approach, involving a RCT and in-depth interviews. The proof-of-concept study will employ a stepped wedge RCT design, whereby the intervention will be sequentially rolled out to participants over a number of time periods. The order in which individuals receive the intervention will be determined at random. The strength of this design is that it can properly address the efficacy question, while avoiding the dilemma of withholding the intervention to some participants, as in a parallel group design.

Study Design

Study Type:
Interventional
Actual Enrollment :
61 participants
Allocation:
Randomized
Intervention Model:
Crossover Assignment
Masking:
Single (Outcomes Assessor)
Primary Purpose:
Supportive Care
Official Title:
Improving Physical Activity Using an Online Monitoring Tool: a New Model of Care for Knee Osteoarthritis
Actual Study Start Date :
Nov 2, 2015
Actual Primary Completion Date :
May 17, 2017
Actual Study Completion Date :
May 25, 2017

Arms and Interventions

Arm Intervention/Treatment
Experimental: Immediate Intervention Group

Education session, Fitbit Flex, and remote coaching by a PT: These three components of the intervention will be delivered to the participants in Month 1 and 2. At the end of the education session, the PT will help participants set personal activity goals. In Month 1 and 2, participants will use the Fitbit Flex. The PT will review the progress with participants via 20-minute bi-weekly phone calls and progressively modify their activities. In Month 3-6, participants will keep the Fitbit and continue to use it with access to a PT via email as needed. In addition, they will receive a monthly e-newsletter about arthritis research that is not related to physical activity.

Behavioral: Education session, Fitbit Flex, and remote coaching by a PT
Participants will receive a brief education session, use of a commercially available physical activity tracker called Fitbit Flex, and remote counseling by a PT. Intervention will be received immediately.

Experimental: Delayed Intervention Group

Same intervention with a 2 month delay: The Delayed Intervention Group (control group) will receive the same monthly e-newsletter in Months 1-2. The full intervention will be initiated in Month 3 with a brief education session, use of Fitbit Flex, and counseling by a physiotherapist. In Month 4, they will continue the intervention without the PT phone calls. Participants will keep the Fitbit for Month 5-6, and have email access to PT as needed.

Behavioral: Same intervention with a 2 month delay
The Delayed Intervention Group will receive the same intervention as the Immediate Intervention Group, but with a 2 month delay.

Outcome Measures

Primary Outcome Measures

  1. Time Spent in Moderate-to-Vigorous Physical Activity (MVPA) [Baseline; 2 months, 4 months and 6 months from baseline]

    Participants wore a SenseWear Mini accelerometer for 7 days at baseline, and Months 2, 4, and 6. We calculated the average daily time (minutes) spent in MVPA accumulated in bouts. A bout is defined as 10 or more consecutive minutes at the level of 3 or higher METs, with allowance for interruption of up to 1 minute below the threshold.

Secondary Outcome Measures

  1. Time Spent in Sedentary Behaviors [Change from baseline in time spent sedentary behaviors at 2 months, 4 months, and 6 months.]

    We calculated the average daily time spent with an energy expenditure of 1.5 METs or lower, occurring in bouts of 20 minutes or more during waking hours.

  2. KOOS - Symptoms [Baseline; 2 months, 4 months and 6 months from baseline]

    Symptoms were measured by Knee Injury and OA Outcome Score (KOOS). The KOOS measures knee osteoarthritis disease status and consists of five sub-scales: knee pain, stiffness, daily activity, sports/recreation, and quality of life. Scores range from 0 to 100, with higher being better.

  3. KOOS - Pain [Baseline; 2 months, 4 months and 6 months from baseline]

    Pain was measured by Knee Injury and OA Outcome Score (KOOS). The KOOS measures knee osteoarthritis disease status and consists of five sub-scales: knee pain, stiffness, daily activity, sports/recreation, and quality of life. Scores range from 0 to 100, with higher being better.

  4. KOOS - Activity of Daily Living [Baseline; 2 months, 4 months and 6 months from baseline]

    Activity of Daily Living was measured by Knee Injury and OA Outcome Score (KOOS). The KOOS measures knee osteoarthritis disease status and consists of five sub-scales: knee pain, stiffness, daily activity, sports/recreation, and quality of life. Scores range from 0 to 100, with higher being better.

  5. KOOS - Sports & Recreation [Baseline; 2 months, 4 months and 6 months from baseline]

    Sports & Recreation was measured by Knee Injury and OA Outcome Score (KOOS). The KOOS measures knee osteoarthritis disease status and consists of five sub-scales: knee pain, stiffness, daily activity, sports/recreation, and quality of life. Scores range from 0 to 100, with higher being better.

  6. KOOS - Quality of Life [Baseline; 2 months, 4 months and 6 months from baseline]

    Quality of Life was measured by Knee Injury and OA Outcome Score (KOOS). The KOOS measures knee osteoarthritis disease status and consists of five sub-scales: knee pain, stiffness, daily activity, sports/recreation, and quality of life. Scores range from 0 to 100, with higher being better.

  7. Partners in Health Scale [Baseline; 2 months, 4 months and 6 months from baseline]

    The Partners in Health Scale is a 12-item measure designed to assess self-efficacy, knowledge of health conditions and treatment, and self-management behaviors such as adopting a healthy lifestyle. Scores range from 0 to 96, with lower being better.

Eligibility Criteria

Criteria

Ages Eligible for Study:
19 Years and Older
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Inclusion Criteria:
  • Have a physician confirmed diagnosis of knee osteoarthritis OR are both 1) over 50, and 2) have experienced 4 weeks of pain, aching, or discomfort in or around the knee during the last year (equal to or more than 28 separate or consecutive days).

  • Have no previous diagnosis of rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, polymyalgia rheumatica, connective tissue diseases, fibromyalgia or gout.

  • Have no history of using disease-modifying anti-rheumatic drugs or gout medications.

  • Have no prior knee replacement surgery, and not on a waiting list for total knee replacement surgery.

  • Have no history of acute injury to the knee in the past 6 months.

  • Have not had surgery in the back, hip, knee, foot or ankle joints in the past 12 months.

  • Have an email address and daily access to a computer with internet connection.

  • Be able to attend a 1.5-hour education session at the Mary Pack Arthritis Centre.

  • Be able to attend a 1-hour assessment session at Vancouver General Hospital prior to beginning the study, and again 2 and 4 months later.

In addition, participants may be eligible (not required) to partake in a brain magnetic resonance imaging (MRI) assessment if they:

  • Do not have a pacemaker, brain aneurysm clip, cochlear implant, electrical stimulator for nerves or bones, implanted infusion pump, artificial heart valve, orthopaedic hardware, other metallic prostheses, coil, catheter or filter in any blood vessel, ear or eye implant, bullets or other metallic fragments.

  • Do not have a history of any eye injury involving metal fragments.

  • Do not have a history of claustrophobia (i.e. fearful of being in closed or narrow spaces).

  • Have not had surgery or tattoos within the past 6 weeks.

  • Are able to attend a 1-hour session at the UBC 3T Magnetic Resonance Imaging Centre (2221 Wesbrook Mall, Vancouver).

Exclusion Criteria:
  • Have a body mass index of equal to or greater than 40

  • Have received a steroid injection in a knee in the last 6 months

  • Have received a hyaluronate injection in a knee in the last 6 months

  • Use medication that may impair activity tolerance (e.g. beta blockers)

  • Are at risk when exercising, as identified by the Physical Activity Readiness Questionnaire (PAR-Q)

Contacts and Locations

Locations

Site City State Country Postal Code
1 Arthritis Research Canada Richmond British Columbia Canada V6X 2C7

Sponsors and Collaborators

  • University of British Columbia
  • Simon Fraser University
  • Arthritis Research Centre of Canada
  • Vancouver General Hospital

Investigators

  • Principal Investigator: Linda Li, PhD, Arthritis Research Canada

Study Documents (Full-Text)

More Information

Additional Information:

Publications

None provided.
Responsible Party:
Linda Li, Professor, University of British Columbia
ClinicalTrials.gov Identifier:
NCT02315664
Other Study ID Numbers:
  • H14-01762
First Posted:
Dec 12, 2014
Last Update Posted:
Oct 28, 2019
Last Verified:
Sep 1, 2019
Individual Participant Data (IPD) Sharing Statement:
No
Plan to Share IPD:
No
Keywords provided by Linda Li, Professor, University of British Columbia
Additional relevant MeSH terms:

Study Results

Participant Flow

Recruitment Details The recruitment period was from February 2015 - October 2016. Recruitment strategies included placing study advertisement material at Community Health Centres and Mary Pack Arthritis Centre. We also had study advertisement disseminated through Arthritis Research Canada website and group collaborators' group newsletters.
Pre-assignment Detail After enrollment, participants completed the baseline assessment, and after completion of baseline participants were randomly assigned to the immediate group or the delayed group (ie, control) in 1:1 allocation ratio.
Arm/Group Title Immediate Intervention Group Delayed Intervention Group
Arm/Group Description Education session, Fitbit Flex, and remote coaching by a PT: These three components of the intervention will be delivered to the participants in Month 1 and 2. At the end of the education session, the PT will help participants set personal activity goals. In Month 1 and 2, participants will use the Fitbit Flex. The PT will review the progress with participants via 20-minute bi-weekly phone calls and progressively modify their activities. In Month 3-6, participants will keep the Fitbit and continue to use it with access to a PT via email as needed. In addition, they will receive a monthly e-newsletter about arthritis research that is not related to physical activity. Education session, Fitbit Flex, and remote coaching by a PT: Participants will receive a brief education session, use of a commercially available physical activity tracker called Fitbit Flex, and remote counseling by a PT. Intervention will be received immediately. Same intervention with a 2 month delay: The Delayed Intervention Group (control group) will receive the same monthly e-newsletter in Months 1-2. The full intervention will be initiated in Month 3 with a brief education session, use of Fitbit Flex, and counseling by a physiotherapist. In Month 4, they will continue the intervention without the PT phone calls. Participants will keep the Fitbit for Month 5-6, and have email access to PT as needed. Same intervention with a 2 month delay: The Delayed Intervention Group will receive the same intervention as the Immediate Intervention Group, but with a 2 month delay.
Period Title: Overall Study
STARTED 30 31
COMPLETED 29 27
NOT COMPLETED 1 4

Baseline Characteristics

Arm/Group Title Immediate Intervention Group Delayed Intervention Group Total
Arm/Group Description Education session, Fitbit Flex, and remote coaching by a PT: These three components of the intervention will be delivered to the participants in Month 1 and 2. At the end of the education session, the PT will help participants set personal activity goals. In Month 1 and 2, participants will use the Fitbit Flex. The PT will review the progress with participants via 20-minute bi-weekly phone calls and progressively modify their activities. In Month 3-6, participants will keep the Fitbit and continue to use it with access to a PT via email as needed. In addition, they will receive a monthly e-newsletter about arthritis research that is not related to physical activity. Same intervention with a 2 month delay: The Delayed Intervention Group (control group) will receive the same monthly e-newsletter in Months 1-2. The full intervention will be initiated in Month 3 with a brief education session, use of Fitbit Flex, and counseling by a physiotherapist. In Month 4, they will continue the intervention without the PT phone calls. Participants will keep the Fitbit for Month 5-6, and have email access to PT as needed. Total of all reporting groups
Overall Participants 30 31 61
Age (years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [years]
61.3
(9.4)
62.1
(8.5)
61.7
(8.9)
Sex: Female, Male (Count of Participants)
Female
22
73.3%
28
90.3%
50
82%
Male
8
26.7%
3
9.7%
11
18%
Race and Ethnicity Not Collected (Count of Participants)
Count of Participants [Participants]
0
0%
Region of Enrollment (participants) [Number]
Canada
30
100%
31
100%
61
100%
Marital Status (Count of Participants)
Married/Common Law
19
63.3%
14
45.2%
33
54.1%
Separated/Divorced
7
23.3%
8
25.8%
15
24.6%
Widowed/Never married/Other
4
13.3%
9
29%
13
21.3%
Gross annual household income (CAN$) (Count of Participants)
≤12,000
0
0%
0
0%
0
0%
12,001-24,000
1
3.3%
2
6.5%
3
4.9%
24,001-40,000
4
13.3%
2
6.5%
6
9.8%
40,001-60,000
5
16.7%
6
19.4%
11
18%
60,001-80,000
9
30%
4
12.9%
13
21.3%
80,001-100,000
2
6.7%
3
9.7%
5
8.2%
>100,000
5
16.7%
6
19.4%
11
18%
No answer
4
13.3%
8
25.8%
12
19.7%
Diagnosed with OA (Count of Participants)
Yes
26
86.7%
26
83.9%
52
85.2%
No, but met the "likely OA" criteria
4
13.3%
5
16.1%
9
14.8%
In general would you say your health is... (Count of Participants)
Excellent
1
3.3%
0
0%
1
1.6%
Very good
15
50%
14
45.2%
29
47.5%
Good
10
33.3%
14
45.2%
24
39.3%
Fair
4
13.3%
3
9.7%
7
11.5%
Poor
0
0%
0
0%
0
0%
Compared to one year ago, how would you rate your health in general now? (Count of Participants)
Much better
2
6.7%
2
6.5%
4
6.6%
Somewhat better
6
20%
3
9.7%
9
14.8%
About the same
12
40%
15
48.4%
27
44.3%
Somewhat worse
10
33.3%
11
35.5%
21
34.4%
Much worse
0
0%
0
0%
0
0%
Number of comorbid conditions (Comorbid conditions) [Median (Inter-Quartile Range) ]
Median (Inter-Quartile Range) [Comorbid conditions]
2.0
4.0
3.0
Body mass index (kg/m^2) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [kg/m^2]
29.2
(5.5)
29.2
(4.8)
29.2
(5.1)

Outcome Measures

1. Primary Outcome
Title Time Spent in Moderate-to-Vigorous Physical Activity (MVPA)
Description Participants wore a SenseWear Mini accelerometer for 7 days at baseline, and Months 2, 4, and 6. We calculated the average daily time (minutes) spent in MVPA accumulated in bouts. A bout is defined as 10 or more consecutive minutes at the level of 3 or higher METs, with allowance for interruption of up to 1 minute below the threshold.
Time Frame Baseline; 2 months, 4 months and 6 months from baseline

Outcome Measure Data

Analysis Population Description
The number of participants analyzed is the same as the number of participants assigned to each group.
Arm/Group Title Immediate Intervention Group Delayed Intervention Group
Arm/Group Description Education session, Fitbit Flex, and remote coaching by a PT: These three components of the intervention will be delivered to the participants in Month 1 and 2. At the end of the education session, the PT will help participants set personal activity goals. In Month 1 and 2, participants will use the Fitbit Flex. The PT will review the progress with participants via 20-minute bi-weekly phone calls and progressively modify their activities. In Month 3-6, participants will keep the Fitbit and continue to use it with access to a PT via email as needed. In addition, they will receive a monthly e-newsletter about arthritis research that is not related to physical activity. Same intervention with a 2 month delay: The Delayed Intervention Group (control group) will receive the same monthly e-newsletter in Months 1-2. The full intervention will be initiated in Month 3 with a brief education session, use of Fitbit Flex, and counseling by a physiotherapist. In Month 4, they will continue the intervention without the PT phone calls. Participants will keep the Fitbit for Month 5-6, and have email access to PT as needed.
Measure Participants 30 31
Baseline
62.1
(54.6)
65.3
(77.4)
2 months
75.5
(54.3)
50.0
(46.8)
4 months
62.6
(56.3)
60.1
(76.8)
6 months
65.6
(48.5)
70.7
(71.9)
2. Secondary Outcome
Title Time Spent in Sedentary Behaviors
Description We calculated the average daily time spent with an energy expenditure of 1.5 METs or lower, occurring in bouts of 20 minutes or more during waking hours.
Time Frame Change from baseline in time spent sedentary behaviors at 2 months, 4 months, and 6 months.

Outcome Measure Data

Analysis Population Description
The number of participants analyzed is the same as the number of participants assigned to each group.
Arm/Group Title Immediate Intervention Group Delayed Intervention Group
Arm/Group Description Education session, Fitbit Flex, and remote coaching by a PT: These three components of the intervention will be delivered to the participants in Month 1 and 2. At the end of the education session, the PT will help participants set personal activity goals. In Month 1 and 2, participants will use the Fitbit Flex. The PT will review the progress with participants via 20-minute bi-weekly phone calls and progressively modify their activities. In Month 3-6, participants will keep the Fitbit and continue to use it with access to a PT via email as needed. In addition, they will receive a monthly e-newsletter about arthritis research that is not related to physical activity. Same intervention with a 2 month delay: The Delayed Intervention Group (control group) will receive the same monthly e-newsletter in Months 1-2. The full intervention will be initiated in Month 3 with a brief education session, use of Fitbit Flex, and counseling by a physiotherapist. In Month 4, they will continue the intervention without the PT phone calls. Participants will keep the Fitbit for Month 5-6, and have email access to PT as needed.
Measure Participants 30 31
Baseline
464.1
(137.7)
497.4
(200.7)
2 months
437.6
(133.9)
503.0
(160.7)
4 months
505.9
(167.2)
508.9
(189)
6 months
435.8
(138.8)
496.0
(179.5)
3. Secondary Outcome
Title KOOS - Symptoms
Description Symptoms were measured by Knee Injury and OA Outcome Score (KOOS). The KOOS measures knee osteoarthritis disease status and consists of five sub-scales: knee pain, stiffness, daily activity, sports/recreation, and quality of life. Scores range from 0 to 100, with higher being better.
Time Frame Baseline; 2 months, 4 months and 6 months from baseline

Outcome Measure Data

Analysis Population Description
The number of participants analyzed is the same as the number of participants assigned to each group.
Arm/Group Title Immediate Intervention Group Delayed Intervention Group
Arm/Group Description Education session, Fitbit Flex, and remote coaching by a PT: These three components of the intervention will be delivered to the participants in Month 1 and 2. At the end of the education session, the PT will help participants set personal activity goals. In Month 1 and 2, participants will use the Fitbit Flex. The PT will review the progress with participants via 20-minute bi-weekly phone calls and progressively modify their activities. In Month 3-6, participants will keep the Fitbit and continue to use it with access to a PT via email as needed. In addition, they will receive a monthly e-newsletter about arthritis research that is not related to physical activity. Same intervention with a 2 month delay: The Delayed Intervention Group (control group) will receive the same monthly e-newsletter in Months 1-2. The full intervention will be initiated in Month 3 with a brief education session, use of Fitbit Flex, and counseling by a physiotherapist. In Month 4, they will continue the intervention without the PT phone calls. Participants will keep the Fitbit for Month 5-6, and have email access to PT as needed.
Measure Participants 30 31
Baseline
59.8
(16.1)
62.9
(17.2)
2 months
62.6
(15.6)
61.7
(14.5)
4 months
62.4
(14.7)
63.4
(16.7)
6 months
62.1
(15.3)
61.4
(19.8)
4. Secondary Outcome
Title KOOS - Pain
Description Pain was measured by Knee Injury and OA Outcome Score (KOOS). The KOOS measures knee osteoarthritis disease status and consists of five sub-scales: knee pain, stiffness, daily activity, sports/recreation, and quality of life. Scores range from 0 to 100, with higher being better.
Time Frame Baseline; 2 months, 4 months and 6 months from baseline

Outcome Measure Data

Analysis Population Description
The number of participants analyzed is the same as the number of participants assigned to each group.
Arm/Group Title Immediate Intervention Group Delayed Intervention Group
Arm/Group Description Education session, Fitbit Flex, and remote coaching by a PT: These three components of the intervention will be delivered to the participants in Month 1 and 2. At the end of the education session, the PT will help participants set personal activity goals. In Month 1 and 2, participants will use the Fitbit Flex. The PT will review the progress with participants via 20-minute bi-weekly phone calls and progressively modify their activities. In Month 3-6, participants will keep the Fitbit and continue to use it with access to a PT via email as needed. In addition, they will receive a monthly e-newsletter about arthritis research that is not related to physical activity. Same intervention with a 2 month delay: The Delayed Intervention Group (control group) will receive the same monthly e-newsletter in Months 1-2. The full intervention will be initiated in Month 3 with a brief education session, use of Fitbit Flex, and counseling by a physiotherapist. In Month 4, they will continue the intervention without the PT phone calls. Participants will keep the Fitbit for Month 5-6, and have email access to PT as needed.
Measure Participants 30 31
Baseline
66.2
(17.5)
65.1
(17.9)
2 months
70.9
(17)
64.8
(14.6)
4 months
67.5
(15.5)
66.3
(15.2)
6 months
68.6
(17.5)
66.2
(16.4)
5. Secondary Outcome
Title KOOS - Activity of Daily Living
Description Activity of Daily Living was measured by Knee Injury and OA Outcome Score (KOOS). The KOOS measures knee osteoarthritis disease status and consists of five sub-scales: knee pain, stiffness, daily activity, sports/recreation, and quality of life. Scores range from 0 to 100, with higher being better.
Time Frame Baseline; 2 months, 4 months and 6 months from baseline

Outcome Measure Data

Analysis Population Description
The number of participants analyzed is the same as the number of participants assigned to each group.
Arm/Group Title Immediate Intervention Group Delayed Intervention Group
Arm/Group Description Education session, Fitbit Flex, and remote coaching by a PT: These three components of the intervention will be delivered to the participants in Month 1 and 2. At the end of the education session, the PT will help participants set personal activity goals. In Month 1 and 2, participants will use the Fitbit Flex. The PT will review the progress with participants via 20-minute bi-weekly phone calls and progressively modify their activities. In Month 3-6, participants will keep the Fitbit and continue to use it with access to a PT via email as needed. In addition, they will receive a monthly e-newsletter about arthritis research that is not related to physical activity. Same intervention with a 2 month delay: The Delayed Intervention Group (control group) will receive the same monthly e-newsletter in Months 1-2. The full intervention will be initiated in Month 3 with a brief education session, use of Fitbit Flex, and counseling by a physiotherapist. In Month 4, they will continue the intervention without the PT phone calls. Participants will keep the Fitbit for Month 5-6, and have email access to PT as needed.
Measure Participants 30 31
Baseline
71.8
(17.5)
74.1
(17.6)
2 months
76
(16.1)
71
(16.5)
4 months
76.6
(17.5)
75.2
(17.2)
6 months
75.1
(15.9)
73.9
(15.8)
6. Secondary Outcome
Title KOOS - Sports & Recreation
Description Sports & Recreation was measured by Knee Injury and OA Outcome Score (KOOS). The KOOS measures knee osteoarthritis disease status and consists of five sub-scales: knee pain, stiffness, daily activity, sports/recreation, and quality of life. Scores range from 0 to 100, with higher being better.
Time Frame Baseline; 2 months, 4 months and 6 months from baseline

Outcome Measure Data

Analysis Population Description
The number of participants analyzed is the same as the number of participants assigned to each group.
Arm/Group Title Immediate Intervention Group Delayed Intervention Group
Arm/Group Description Education session, Fitbit Flex, and remote coaching by a PT: These three components of the intervention will be delivered to the participants in Month 1 and 2. At the end of the education session, the PT will help participants set personal activity goals. In Month 1 and 2, participants will use the Fitbit Flex. The PT will review the progress with participants via 20-minute bi-weekly phone calls and progressively modify their activities. In Month 3-6, participants will keep the Fitbit and continue to use it with access to a PT via email as needed. In addition, they will receive a monthly e-newsletter about arthritis research that is not related to physical activity. Same intervention with a 2 month delay: The Delayed Intervention Group (control group) will receive the same monthly e-newsletter in Months 1-2. The full intervention will be initiated in Month 3 with a brief education session, use of Fitbit Flex, and counseling by a physiotherapist. In Month 4, they will continue the intervention without the PT phone calls. Participants will keep the Fitbit for Month 5-6, and have email access to PT as needed.
Measure Participants 30 31
Baseline
47.3
(26.6)
52.7
(27.7)
2 months
49.3
(24.9)
47
(23.3)
4 months
50
(25.6)
48.9
(27.7)
6 months
50.4
(26.3)
49.8
(29.2)
7. Secondary Outcome
Title KOOS - Quality of Life
Description Quality of Life was measured by Knee Injury and OA Outcome Score (KOOS). The KOOS measures knee osteoarthritis disease status and consists of five sub-scales: knee pain, stiffness, daily activity, sports/recreation, and quality of life. Scores range from 0 to 100, with higher being better.
Time Frame Baseline; 2 months, 4 months and 6 months from baseline

Outcome Measure Data

Analysis Population Description
The number of participants analyzed is the same as the number of participants assigned to each group.
Arm/Group Title Immediate Intervention Group Delayed Intervention Group
Arm/Group Description Education session, Fitbit Flex, and remote coaching by a PT: These three components of the intervention will be delivered to the participants in Month 1 and 2. At the end of the education session, the PT will help participants set personal activity goals. In Month 1 and 2, participants will use the Fitbit Flex. The PT will review the progress with participants via 20-minute bi-weekly phone calls and progressively modify their activities. In Month 3-6, participants will keep the Fitbit and continue to use it with access to a PT via email as needed. In addition, they will receive a monthly e-newsletter about arthritis research that is not related to physical activity. Same intervention with a 2 month delay: The Delayed Intervention Group (control group) will receive the same monthly e-newsletter in Months 1-2. The full intervention will be initiated in Month 3 with a brief education session, use of Fitbit Flex, and counseling by a physiotherapist. In Month 4, they will continue the intervention without the PT phone calls. Participants will keep the Fitbit for Month 5-6, and have email access to PT as needed.
Measure Participants 30 31
Baseline
41
(19.8)
44.6
(16.3)
2 months
47.2
(18.9)
42.4
(16.8)
4 months
45.4
(17.6)
47.5
(13.6)
6 months
44.9
(17.9)
48.1
(19.1)
8. Secondary Outcome
Title Partners in Health Scale
Description The Partners in Health Scale is a 12-item measure designed to assess self-efficacy, knowledge of health conditions and treatment, and self-management behaviors such as adopting a healthy lifestyle. Scores range from 0 to 96, with lower being better.
Time Frame Baseline; 2 months, 4 months and 6 months from baseline

Outcome Measure Data

Analysis Population Description
The number of participants analyzed is the same as the number of participants assigned to each group.
Arm/Group Title Immediate Intervention Group Delayed Intervention Group
Arm/Group Description Education session, Fitbit Flex, and remote coaching by a PT: These three components of the intervention will be delivered to the participants in Month 1 and 2. At the end of the education session, the PT will help participants set personal activity goals. In Month 1 and 2, participants will use the Fitbit Flex. The PT will review the progress with participants via 20-minute bi-weekly phone calls and progressively modify their activities. In Month 3-6, participants will keep the Fitbit and continue to use it with access to a PT via email as needed. In addition, they will receive a monthly e-newsletter about arthritis research that is not related to physical activity. Same intervention with a 2 month delay: The Delayed Intervention Group (control group) will receive the same monthly e-newsletter in Months 1-2. The full intervention will be initiated in Month 3 with a brief education session, use of Fitbit Flex, and counseling by a physiotherapist. In Month 4, they will continue the intervention without the PT phone calls. Participants will keep the Fitbit for Month 5-6, and have email access to PT as needed.
Measure Participants 30 31
Baseline
18.4
(12.6)
20.5
(12.8)
2 months
14.9
(11.4)
18.3
(13.7)
4 months
14.3
(10.1)
14.9
(9.6)
6 months
12.9
(9.2)
13.1
(9.2)

Adverse Events

Time Frame During the data collection for the randomized controlled trial, adverse event data was tracked using a monthly log (self-reported) by the participant.
Adverse Event Reporting Description We tracked self-reported adverse events (falls, cardiovascular and musculoskeletal events).
Arm/Group Title Immediate Intervention Group Delayed Intervention Group
Arm/Group Description Education session, Fitbit Flex, and remote coaching by a PT: These three components of the intervention will be delivered to the participants in Month 1 and 2. At the end of the education session, the PT will help participants set personal activity goals. In Month 1 and 2, participants will use the Fitbit Flex. The PT will review the progress with participants via 20-minute bi-weekly phone calls and progressively modify their activities. In Month 3-6, participants will keep the Fitbit and continue to use it with access to a PT via email as needed. In addition, they will receive a monthly e-newsletter about arthritis research that is not related to physical activity. Education session, Fitbit Flex, and remote coaching by a PT: Participants will receive a brief education session, use of a commercially available physical activity tracker called Fitbit Flex, and remote counseling by a PT. Intervention will be received immediately. Same intervention with a 2 month delay: The Delayed Intervention Group (control group) will receive the same monthly e-newsletter in Months 1-2. The full intervention will be initiated in Month 3 with a brief education session, use of Fitbit Flex, and counseling by a physiotherapist. In Month 4, they will continue the intervention without the PT phone calls. Participants will keep the Fitbit for Month 5-6, and have email access to PT as needed. Same intervention with a 2 month delay: The Delayed Intervention Group will receive the same intervention as the Immediate Intervention Group, but with a 2 month delay.
All Cause Mortality
Immediate Intervention Group Delayed Intervention Group
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 0/30 (0%) 0/31 (0%)
Serious Adverse Events
Immediate Intervention Group Delayed Intervention Group
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 0/30 (0%) 0/31 (0%)
Other (Not Including Serious) Adverse Events
Immediate Intervention Group Delayed Intervention Group
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 0/30 (0%) 0/31 (0%)

Limitations/Caveats

Our sample was relatively active; hence, the results may not be generalizable to people with knee OA who are more sedentary. Also, the long-term effect of the intervention remained unclear.

More Information

Certain Agreements

Principal Investigators are NOT employed by the organization sponsoring the study.

There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.

Results Point of Contact

Name/Title Dr. Linda Li, Professor, University of British Columbia
Organization Arthritis Research Canada
Phone 604-207-4020
Email lli@arthritisresearch.ca
Responsible Party:
Linda Li, Professor, University of British Columbia
ClinicalTrials.gov Identifier:
NCT02315664
Other Study ID Numbers:
  • H14-01762
First Posted:
Dec 12, 2014
Last Update Posted:
Oct 28, 2019
Last Verified:
Sep 1, 2019