Collaborative-care Intervention to Promote Physical Activity After Total Knee Arthroplasty
Condition: Osteoarthritis
MeSH terms: Osteoarthritis
Study type: Interventional

Summary: 
      The investigators have learned that knee replacement patients are not more physically active
      after surgery. This is true even though their pain is less compared to before surgery. This
      low level of physical activity is not healthy. It can increase the chances of weight gain,
      which can create other issues. It can also lessen physical function. Some studies have looked
      at physical activity feedback systems to increase how active people are. Studies have
      investigated face to face patient group meetings for this,too. These systems and meetings can
      increase physical activity. The investigators will study the effects of a physical activity
      monitors with group meetings after knee replacement. The investigators hypothesize that
      physical activity levels and physical function will increase. The investigators goal is to
      help knee replacement patients lead healthier lives and maintain or enhance their physical
      function.
    

Detailed description: 
      More than 650,000 total knee arthroplasties (TKAs) are performed annually to alleviate pain
      and disability associated with osteoarthritis (OA); a chronic, degenerative condition that
      compromises the quality of life of 37% of adults over age 60. With the aging of the
      population, an estimated 3.5 million TKAs will be performed annually by 2030. Despite
      improvements in pain and self-reported function, physical activity after TKA remains at
      pre-operative, sedentary levels (<5,000 steps/day). Physical activity in TKA confers powerful
      protective effects against common post-surgical sequelae including increased weight gain
      (mean=6.4 kg, 2 years post TKA), decreased functional performance, increased risk/progression
      of co-morbid conditions (e.g. type 2 diabetes mellitus, cardiovascular disease), and
      progression of knee and hip osteoarthritis which may necessitate additional joint replacement
      in the contralateral limb. An intervention aimed at improved self-management of physical
      activity may aid patients in overcoming habitual lifestyle patterns of low physical activity
      secondary to knee pain prior to TKA.

      Recent investigations on the effects of real-time, user-friendly, electronic physical
      activity feedback (PAF) systems and face-to-face (FTF) patient group meetings aimed to
      promote self-management of physical activity suggest that such interventions can successfully
      increase physical activity. Therefore, the investigators propose a randomized, controlled
      trial to assess efficacy and feasibility of a physical activity intervention combined with
      FTF group meetings (PAF+FTF) initiated within one month of patients' discharge from
      outpatient rehabilitation for TKA compared to a control group receiving standard care (CON).
      This type of intervention is surprisingly novel to this patient population and is not common
      practice in rehabilitation following TKA.
    

Intervention name(s): Physical activity feedback with group meetings; Control
Intervention type(s): Other; Other
Intervention description(s): Physical activity feedback; No intervention
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment