- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03212859
Coach2Move: Sustainable in Daily Practice
Study Overview
Status
Intervention / Treatment
Detailed Description
In a previous trial, researchers demonstrated that the Coach2Move approach is superior to regular physiotherapy in terms of increasing physical activity, reducing frailty, improving quality of life and reducing healthcare costs. In short, in less physiotherapeutic sessions, better outcomes were realized.
Despite these promising findings, the research group still has questions regarding the generalisability of these findings. The reservations towards the generalisability of the approach are caused by the following:
- A modest (n=130), yet somewhat selective study sample was included: nearly half of the eligible individuals declined randomisation and thereby participation. An understanding is needed how this group of eligible non volunteers respond to Coach2Move. Therefore, a study design that avoids randomisation at the patient level will be used.
- The Coach2Move approach significantly increased the level of moderate physical activity among the treatment group and reduced levels of frailty significantly after 6 months, but the clinical importance of these findings is still unclear. Thus, a replication of the effects in the light of physical functioning is needed in a larger more variable study population and with a longer follow-up.
In addition, the results from the earlier carried out RCT concerning the cost-effectiveness of Coach2Move have to be replicated on a larger scale.
For the reasons mentioned above, it is important to further implement Coach2Move and study its effect, costs, and feasibility in current practice. A stepped wedge cluster randomised trial design is chosen because in the opinion of the researchers, the implementation strategy will do more good than harm (making a parallel design, in which certain practices do not receive the intervention or to withdraw the intervention as would occur in a cross-over design, is unethical) and it furthermore minimizes contamination.
The objective of this study is to assess the cost-effectiveness of the implementation of a patient and context focused tailored coaching intervention (Coach2Move) in the daily physiotherapy practice for older adults with mobility problems compared to usual physiotherapy. The hypothesis is that Coach2Move leads to better physical outcomes and lower costs than usual care.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Gelderland
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Nijmegen, Gelderland, Netherlands, 6500 HB, PO. 9101
- Ward Heij
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Aged 70 years or older
- Community-dwelling
- mobility related problems or problems related to activities of daily living
- sedentary lifestyle or are at risk of losing an active lifestyle
Exclusion Criteria:
- Patients who are not ambulatory after treatment and/or are in palliative phase.
- Patients who are indicated to become institutionalised in the near future.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Coach2Move Intervention Group
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Coach2Move is a multicomponent physiotherapeutic approach in addition to usual care physiotherapy consisting of:
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Active Comparator: Usual Care
Usual care physiotherapy among older adults
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Usual care physiotherapy among older adults:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Self-reported Physical Activity
Time Frame: 27 months
|
The primary outcome of the study is physical activity measured by the LAPAQ questionnaire, subscale moderate activity.
This subscale of the LAPAQ is a comprehensive questionnaire on diverse (physical) activities of daily living with moderate intensity including walking, riding a bicycle etc. and is specifically designed to assess habitual physical activity of the elderly.
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27 months
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Functional Mobility
Time Frame: 27 months
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The key secondary outcome is functional mobility as measured by the Timed Up and Go test.
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27 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Functional Status
Time Frame: 12 months
|
The Patient Specific Complaints Scale is used to measure the functional status of a patient.
The patients select 3-5 most important mobility problems in daily life and are the most important goals to improve.
The degree of hinder is scored by the patient on a 10-point numeric scale.
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12 months
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Cost effectiveness
Time Frame: 27 months
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The direct costs of regular physiotherapy and Coach2Move will be determined on a per patient basis. On patient level, volumes of care will be measured prospectively using medical records and cost questionnaires. Next will be determining the cost prices for each volume of consumption in order to use these for the volumes registered for each participating patient. Both outcome measures will be aggregated to one reported value (cost per volume x volumes used). A comparison in costs will be made between the Coach2Move and usual care groups. |
27 months
|
Patient Satisfaction
Time Frame: 27 months
|
The Global Perceived Satisfaction and Effect score is used to measure the patients' satisfaction about the intervention and the perceived effect on a 7-point Likert scale ranging from very unsatisfied to very much satisfied and very much deterioration to very much improvement, respectively.
|
27 months
|
Level of Frailty
Time Frame: 27 months
|
To measure the level of frailty and participation, the Evaluative Frailty Index is used.
This questionnaire consists of 50 items on deficits in health (symptoms, signs and disabilities) in multiple domains (physical, psychological, social and general health status).
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27 months
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Implementability
Time Frame: 27 months
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group interviews with PT's and PTG's within each practice will inform us about views and experiences of facilitators and barriers in delivering the Coach2Move interventions and views on which elements on the Coach2Move were effective and which were not, and if the education, peer assessment, EPD, and measurement procedures were viewed as helpful or unhelpful in supporting them to realize behavioural change strategies including needs assessment, problem analysis, shared decisions on SMARTI goals, and monitoring feedback
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27 months
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Budget Impact
Time Frame: 27 months
|
lts purpose is to estimate the financial consequences of adoption and diffusion of standard use of the Coach2Move approach in the Netherlands. Several scenarios will be evaluated. The aim is to assess these consequences in the medium-long term from the various budget holders' perspectives 1) wider societal perspective; 2) the more narrow perspective of the public purse; 3) the perspective of the health insurers; 4) the perspective of the health care provider. The Budget Impact Analysis will be assessed through modelling and analysed in a probabilistic way. Deterministic uncertainty concerning the analysis' input such as the perspective, pricing parameters, time horizon, uptake, etc. will be dealt with by generating the budget impact as a series of scenario analyses covering a relevant range of costs. |
27 months
|
Collaborators and Investigators
Investigators
- Principal Investigator: Ward Heij, MSc, Radboud University Medical Center
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Other Study ID Numbers
- 104612
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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