Effectiveness of text messages for decreasing inactive behaviour in patients with knee osteoarthritis: a pilot randomised controlled study

Cecilie Bartholdy, Henning Bliddal, Marius Henriksen, Cecilie Bartholdy, Henning Bliddal, Marius Henriksen

Abstract

Background: One of the big contributors to physical inactivity in the elderly population is osteoarthritis (OA) of the knee. Digital motivation seems to have a positive effect on individual physical inactivity level, but limited evidence exists on the effects of digital motivation on patients with knee OA.

Objective: To investigate if motivational text messages reduce time spent physically inactive in patients with knee OA.

Method: This study was designed as an unblinded pilot randomised controlled trial, randomising participants equally (1:1) to an intervention group (motivational text messages) or control group (no intervention). Participants were recruited from six physical therapy clinics in Denmark. Inclusion criteria were age ≥ 18, diagnosed with knee OA, owner of a smartphone or tablet, and participating or commencing participation in the GLA:D® program. The primary outcome was time spent physically inactive, measured with a tri-axial accelerometer mounted on the lateral side of the thigh. Data on OA symptoms were obtained using the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire.

Results: A total of 49 participants were screened, and 38 participants were included and randomised to either the intervention group (n = 19) or the control group (n = 19). No statistically significant difference between the two groups was found in average change of time spent physically inactive (mean difference 13.2 min/day [95% CI - 41.0 to 67.3]; P = 0.63), time spent standing (mean difference 3.0 min/day [95% CI - 22.7 to 28.7]; P = 0.81), or time spent moving (mean difference - 20.4 min/day [95% CI - 63.0 to 22.3]; P = 0.34) nor was there any difference in change between the two groups on KOOS.

Conclusion: Motivational text messages have seemed to have no effect on overall time spent physically inactive.

Trial registration: clinicaltrials.gov, NCT03339011. Registered 9 November 2017.

Keywords: Accelerometer; Knee osteoarthritis; Physical inactivity; Text messages.

Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow of participants throughout the study
Fig. 2
Fig. 2
Graphical illustration of the relationship between responses on self-reported change in weekly time (minutes) spent physically active (horizontal axis) and the average (error bars: standard error) objectively measured change in weekly time (minutes) spent moving. Error bars indicate standard errors of the mean, and positive values on the y-axes indicate an increase in time spent moving. The black columns represent the intervention group, and the grey columns represent the control group

References

    1. WHO . Global Health Risks. Report. 2009.
    1. Hallal PC, Andersen LB, Bull FC, Guthold R, Haskell W, Ekelund U, et al. Global physical activity levels: surveillance progress, pitfalls, and prospects. Lancet. 2012;380(9838):247–257. doi: 10.1016/S0140-6736(12)60646-1.
    1. Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT, et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380(9838):219–229. doi: 10.1016/S0140-6736(12)61031-9.
    1. Chau JY, Grunseit AC, Chey T, Stamatakis E, Brown WJ, Matthews CE, et al. Daily sitting time and all-cause mortality: a meta-analysis. PLoS One. 2013;8(11):e80000. doi: 10.1371/journal.pone.0080000.
    1. Ekelund U, Steene-Johannessen J, Brown WJ, Fagerland MW, Owen N, Powell KE, et al. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. Lancet. 2016;388(10051):1302–1310. doi: 10.1016/S0140-6736(16)30370-1.
    1. Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bull World Health Organ. 2003;81(9):646–656.
    1. Sundhedsstyrrelsen. Kliniske retningslinier: Knæ artrose. 2015.
    1. Cibulka MT, White DM, Woehrle J, Harris-Hayes M, Enseki K, Fagerson TL, et al. Hip pain and mobility deficits--hip osteoarthritis: clinical practice guidelines linked to the international classification of functioning, disability, and health from the orthopaedic section of the American Physical Therapy Association. J Orthop Sports Phys Ther. 2009;39(4):A1–25. doi: 10.2519/jospt.2009.0301.
    1. Fransen M, McConnell S, Harmer AR, Van der Esch M, Simic M, Bennell KL. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2015;1:CD004376.
    1. Williamson W, Kluzek S, Roberts N, Richards J, Arden N, Leeson P, et al. Behavioural physical activity interventions in participants with lower-limb osteoarthritis: a systematic review with meta-analysis. BMJ Open. 2015;5(8):e007642. doi: 10.1136/bmjopen-2015-007642.
    1. Arnold JB, Walters JL, Ferrar KE. Does physical activity increase after total hip or knee arthroplasty for osteoarthritis? A systematic review. J Orthop Sports Phys Ther. 2016;46(6):431–442. doi: 10.2519/jospt.2016.6449.
    1. Orr JA, King RJ. Mobile phone SMS messages can enhance healthy behaviour: a meta-analysis of randomised controlled trials. Health Psychol Rev. 2015;9(4):397–416. doi: 10.1080/17437199.2015.1022847.
    1. Free C, Phillips G, Galli L, Watson L, Felix L, Edwards P, et al. The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: a systematic review. PLoS Med. 2013;10(1):e1001362. doi: 10.1371/journal.pmed.1001362.
    1. Hall AK, Cole-Lewis H, Bernhardt JM. Mobile text messaging for health: a systematic review of reviews. Annu Rev Public Health. 2015;36:393–415. doi: 10.1146/annurev-publhealth-031914-122855.
    1. Newton KH, Wiltshire EJ, Elley CR. Pedometers and text messaging to increase physical activity: randomized controlled trial of adolescents with type 1 diabetes. Diabetes Care. 2009;32(5):813–815. doi: 10.2337/dc08-1974.
    1. Hurling R, Catt M, Boni MD, Fairley BW, Hurst T, Murray P, et al. Using internet and mobile phone technology to deliver an automated physical activity program: randomized controlled trial. J Med Internet Res. 2007;9(2):e7. doi: 10.2196/jmir.9.2.e7.
    1. Fjeldsoe BS, Miller YD, Marshall AL. MobileMums: a randomized controlled trial of an SMS-based physical activity intervention. Ann Behav Med. 2010;39(2):101–111. doi: 10.1007/s12160-010-9170-z.
    1. Prestwich A, Perugini M, Hurling R. Can implementation intentions and text messages promote brisk walking? A randomized trial. Health psychol. 2010;29(1):40–49. doi: 10.1037/a0016993.
    1. Prestwich A, Perugini M, Hurling R. Can the effects of implementation intentions on exercise be enhanced using text messages? Psychol Health. 2009;24(6):677–687. doi: 10.1080/08870440802040715.
    1. Shapiro JR, Bauer S, Hamer RM, Kordy H, Ward D, Bulik CM. Use of text messaging for monitoring sugar-sweetened beverages, physical activity, and screen time in children: a pilot study. J Nutr Educ Behav. 2008;40(6):385–391. doi: 10.1016/j.jneb.2007.09.014.
    1. David P, Buckworth J, Pennell ML, Katz ML, DeGraffinreid CR, Paskett ED. A walking intervention for postmenopausal women using mobile phones and interactive voice response. J Telemed Telecare. 2012;18(1):20–25. doi: 10.1258/jtt.2011.110311.
    1. Fukuoka Y, Kamitani E, Dracup K, Jong SS. New insights into compliance with a mobile phone diary and pedometer use in sedentary women. J Phys Act Health. 2011;8(3):398–403. doi: 10.1123/jpah.8.3.398.
    1. Sirriyeh R, Lawton R, Ward J. Physical activity and adolescents: an exploratory randomized controlled trial investigating the influence of affective and instrumental text messages. Br J Health Psychol. 2010;15(Pt 4):825–840. doi: 10.1348/135910710X486889.
    1. King AC, Ahn DK, Oliveira BM, Atienza AA, Castro CM, Gardner CD. Promoting physical activity through hand-held computer technology. Am J Prev Med. 2008;34(2):138–142. doi: 10.1016/j.amepre.2007.09.025.
    1. Schwerdtfeger AR, Schmitz C, Warken M. Using text messages to bridge the intention-behavior gap? A pilot study on the use of text message reminders to increase objectively assessed physical activity in daily life. Front Psychol. 2012;3:270. doi: 10.3389/fpsyg.2012.00270.
    1. Oliveira CB, Franco MR, Maher CG, Christine Lin CW, Morelhao PK, Araujo AC, et al. Physical activity interventions for increasing objectively measured physical activity levels in patients with chronic musculoskeletal pain: a systematic review. Arthritis Care Res. 2016;68(12):1832–1842. doi: 10.1002/acr.22919.
    1. Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett DR, Jr, Tudor-Locke C, et al. 2011 Compendium of Physical Activities: a second update of codes and MET values. Med Sci Sports Exerc. 2011;43(8):1575–1581. doi: 10.1249/MSS.0b013e31821ece12.
    1. Healy GN, Matthews CE, Dunstan DW, Winkler EA, Owen N. Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003-06. Eur Heart J. 2011;32(5):590–597. doi: 10.1093/eurheartj/ehq451.
    1. Gardner B, Smith L, Lorencatto F, Hamer M, Biddle SJ. How to reduce sitting time? A review of behaviour change strategies used in sedentary behaviour reduction interventions among adults. Health Psychol Rev. 2016;10(1):89–112. doi: 10.1080/17437199.2015.1082146.
    1. Bartholdy C, Gudbergsen H, Bliddal H, Kjærgaard M, Lykkegaard KL, Henriksen M. Reliability and construct validity of the SENS Motion® activity measurement system as a tool to detect sedentary behaviour in patients with knee osteoarthritis. Arthritis. 2018;2018:9. doi: 10.1155/2018/6596278.
    1. Eldridge SM, Chan CL, Campbell MJ, Bond CM, Hopewell S, Thabane L, et al. CONSORT 2010 statement: extension to randomised pilot and feasibility trials. BMJ. 2016;355:i5239. doi: 10.1136/bmj.i5239.
    1. Skou ST, Roos EM. Good Life with osteoArthritis in Denmark (GLA:D): evidence-based education and supervised neuromuscular exercise delivered by certified physiotherapists nationwide. BMC Musculoskelet Disord. 2017;18(1):72. doi: 10.1186/s12891-017-1439-y.
    1. Bossen D, Veenhof C, Van Beek KE, Spreeuwenberg PM, Dekker J, De Bakker DH. Effectiveness of a web-based physical activity intervention in patients with knee and/or hip osteoarthritis: randomized controlled trial. J Med Internet Res. 2013;15(11):e257. doi: 10.2196/jmir.2662.
    1. Owen N, Healy GN, Matthews CE, Dunstan DW. Too much sitting: the population health science of sedentary behavior. Exerc Sport Sci Rev. 2010;38(3):105–113. doi: 10.1097/JES.0b013e3181e373a2.
    1. Roos EM, Toksvig-Larsen S. Knee injury and Osteoarthritis Outcome Score (KOOS) - validation and comparison to the WOMAC in total knee replacement. Health Qual Life Outcomes. 2003;1:17. doi: 10.1186/1477-7525-1-17.
    1. Roos EM, Lohmander LS. The Knee injury and Osteoarthritis Outcome Score (KOOS): from joint injury to osteoarthritis. Health Qual Life Outcomes. 2003;1:64. doi: 10.1186/1477-7525-1-64.
    1. Collins NJ, Misra D, Felson DT, Crossley KM, Roos EM. Measures of knee function: International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS), Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL), Lysholm Knee Scoring Scale, Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Activity Rating Scale (ARS), and Tegner Activity Score (TAS) Arthritis Care Res. 2011;63(Suppl 11):S208–S228. doi: 10.1002/acr.20632.
    1. Thomsen T, Aadahl M, Beyer N, Hetland ML, Loppenthin K, Midtgaard J, et al. The efficacy of motivational counselling and SMS reminders on daily sitting time in patients with rheumatoid arthritis: a randomised controlled trial. Ann Rheum Dis. 2017;76(9):1603–1606. doi: 10.1136/annrheumdis-2016-210953.
    1. Christensen R, Henriksen M, Leeds AR, Gudbergsen H, Christensen P, Sorensen TJ, et al. Effect of weight maintenance on symptoms of knee osteoarthritis in obese patients: a twelve-month randomized controlled trial. Arthritis Care Res. 2015;67(5):640–650. doi: 10.1002/acr.22504.
    1. Davis R, Campbell R, Hildon Z, Hobbs L, Michie S. Theories of behaviour and behaviour change across the social and behavioural sciences: a scoping review. Health Psychol Rev. 2015;9(3):323–344. doi: 10.1080/17437199.2014.941722.
    1. Dunn EE, Gainforth HL, Robertson-Wilson JE. Behavior change techniques in mobile applications for sedentary behavior. Digital Health. 2018;4:1–8. doi: 10.1177/2055207618785798.
    1. Webb TL, Joseph J, Yardley L, Michie S. Using the internet to promote health behavior change: a systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy. J Med Internet Res. 2010;12(1):e4. doi: 10.2196/jmir.1376.
    1. Strath SJ, Kaminsky LA, Ainsworth BE, Ekelund U, Freedson PS, Gary RA, et al. Guide to the assessment of physical activity: clinical and research applications: a scientific statement from the American Heart Association. Circulation. 2013;128(20):2259–2279. doi: 10.1161/01.cir.0000435708.67487.da.
    1. Lollgen H, Bockenhoff A, Knapp G. Physical activity and all-cause mortality: an updated meta-analysis with different intensity categories. Int J Sports Med. 2009;30(3):213–224. doi: 10.1055/s-0028-1128150.
    1. Campbell M, Fitzpatrick R, Haines A, Kinmonth AL, Sandercock P, Spiegelhalter D, et al. Framework for design and evaluation of complex interventions to improve health. BMJ. 2000;321(7262):694–696. doi: 10.1136/bmj.321.7262.694.

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