Effects of a 12-Week Multifaceted Wearable-Based Program for People With Knee Osteoarthritis: Randomized Controlled Trial

Linda C Li, Lynne M Feehan, Hui Xie, Na Lu, Christopher D Shaw, Diane Gromala, Siyi Zhu, J Antonio Aviña-Zubieta, Alison M Hoens, Cheryl Koehn, Johnathan Tam, Stephanie Therrien, Anne F Townsend, Gregory Noonan, Catherine L Backman, Linda C Li, Lynne M Feehan, Hui Xie, Na Lu, Christopher D Shaw, Diane Gromala, Siyi Zhu, J Antonio Aviña-Zubieta, Alison M Hoens, Cheryl Koehn, Johnathan Tam, Stephanie Therrien, Anne F Townsend, Gregory Noonan, Catherine L Backman

Abstract

Background: Current guidelines emphasize an active lifestyle in the management of knee osteoarthritis (OA), but up to 90% of patients with OA are inactive. In a previous study, we demonstrated that an 8-week physiotherapist (PT)-led counseling intervention, with the use of a Fitbit, improved step count and quality of life in patients with knee OA, compared with a control.

Objective: This study aimed to examine the effect of a 12-week, multifaceted wearable-based program on physical activity and patient outcomes in patients with knee OA.

Methods: This was a randomized controlled trial with a delay-control design. The immediate group (IG) received group education, a Fitbit, access to FitViz (a Fitbit-compatible app), and 4 biweekly phone calls from a PT over 8 weeks. Participants then continued using Fitbit and FitViz independently up to week 12. The delay group (DG) received a monthly electronic newsletter in weeks 1 to 12 and started the same intervention in week 14. Participants were assessed in weeks 13, 26, and 39. The primary outcome was time spent in daily moderate-to-vigorous physical activity (MVPA; in bouts ≥10 min) measured with a SenseWear Mini. Secondary outcomes included daily steps, time spent in purposeful activity and sedentary behavior, Knee Injury and OA Outcome Score, Patient Health Questionnaire-9, Partners in Health Scale, Theory of Planned Behavior Questionnaire, and Self-Reported Habit Index.

Results: We enrolled 51 participants (IG: n=26 and DG: n=25). Compared with the IG, the DG accumulated significantly more MVPA time at baseline. The adjusted mean difference in MVPA was 13.1 min per day (95% CI 1.6 to 24.5). A significant effect was also found in the adjusted mean difference in perceived sitting habit at work (0.7; 95% CI 0.2 to 1.2) and during leisure activities (0.7; 95% CI 0.2 to 1.2). No significant effect was found in the remaining secondary outcomes.

Conclusions: A 12-week multifaceted program with the use of a wearable device, an app, and PT counseling improved physical activity in people with knee OA.

Trial registration: ClinicalTrials.gov NCT02585323; https://ichgcp.net/clinical-trials-registry/NCT02585323.

Keywords: counseling; knee osteoarthritis; physical activity; physiotherapy; wearables.

Conflict of interest statement

Conflicts of Interest: None declared.

©Linda C Li, Lynne M Feehan, Hui Xie, Na Lu, Christopher D Shaw, Diane Gromala, Siyi Zhu, J Antonio Aviña-Zubieta, Alison M Hoens, Cheryl Koehn, Johnathan Tam, Stephanie Therrien, Anne F Townsend, Gregory Noonan, Catherine L Backman. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 03.07.2020.

Figures

Figure 1
Figure 1
Consolidated Standards of Reporting Trials flowchart.
Figure 2
Figure 2
Time in moderate-to-vigorous physical activity.
Figure 3
Figure 3
Boxplot of time in moderate-to-vigorous physical activity at baseline and 13 weeks.

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