Coaching program to help Veterans keep up home exercise for knee osteoarthritis

AI summary

From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.

The trial is looking for adults with knee osteoarthritis who get physical therapy in the Veterans Affairs health system. It tests a program to help people keep doing home exercise.

Age

18 Years and older

Sex

All sexes can join

Disease stage

Knee osteoarthritis confirmed in the health record. Knee pain for 3 months, on most days of the previous month, with average pain of 3 on a 0-10 scale. Some difficulty walking or climbing stairs.

Earlier treatment

People who completed physical therapy for knee osteoarthritis in the past year cannot join. No lower limb surgery in the past 6 months.

Main reasons for not taking part

• Systemic rheumatic conditions, fibromyalgia or gout in the knee
• Dementia, psychosis or active substance abuse disorder
• Meniscus or knee ligament tear in the past 6 months, or lower limb surgery in the past 6 months or planned in the next 9 months
• Serious heart or lung problems, such as unstable angina, uncontrolled high blood pressure or heart hospital stay in the past 3 months
• Already meeting national physical activity guidelines, or 3 or more falls in the past 6 months

The registry criteria, word for word

What the trial wants to find out

This project, conducted within the Department of Veterans Affairs Healthcare System (VHA), will test the effectiveness of an intervention to improve adherence to home exercise among Veterans receiving physical therapy (PT) for knee osteoarthritis (OA). The intervention, "Boosting Exercise Adherence in Knee Osteoarthritis" (BOOST-OA), has two phases. During the initiation phase (first 3 months of PT care), patients will receive tools and activities to address outcome expectations, action self-efficacy, goal-setting and monitoring. During the behavior maintenance phase (starting after PT care and continuing for 9 months), patients will receive health coaching calls that address satisfaction with outcomes, relapse prevention planning and independent monitoring. There are three main study aims: (1) examine improvements in patient outcomes, such as physical function, following BOOST-OA; (2) explore patient characteristics that lead to difference in reported improvements; and (3) interview participants and clinicians about their experience with BOOST-OA to inform future implementation.

The 2 groups in the trial

• Usual PT Care (UC)Existing treatment, for comparison

  UC will be delivered by trained clinicians at participating sites. The study team will provide clinicians with guidance and training to standardize core aspects of physical therapy (PT), aligned with best practice recommendations. Clinicians must provide enrolled Veterans with at least 4 PT visits, spaced at least weekly so that Veterans can practice home exercise and receive guidance in exercise progression. All PT visits must be completed within 3 months.

• BOOST-OATreatment being tested

  BOOST-OA includes components that are integrated into physical therapy (PT) visits (concurrent), focused on behavior initiation, as well as components that occur after PT visits have ended (sequential), focused on behavior maintenance. Concurrent components will be delivered in conjunction with usual care PT visits. Clinicians must provide enrolled Veterans with at least 4 PT visits, spaced at least weekly. PT visits must be also completed within 3 months. Sequential components will be delivered by a health coach via phone or video. Health coach sessions will be conducted every other week for the first 2 months (months 4-5), monthly for an additional 3 months (months 6- 8), and every other month for the last 4 months (months 9-12; 9 total contacts). Calls will address strengthening and stretching exercises (≥3 times per week), as well as overall physical activity (e.g., minutes / steps).