Implementation of Tele-Exercise for Management of Knee Osteoarthritis in Older Rural Primary Care Patients

NCT ID: NCT04706702

Last Updated: 2021-01-13

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: NA
• Total Enrollment: 15 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2021-03-01
• Study Completion Date: 2022-02-28

Brief Summary

Knee osteoarthritis (OA) is highly prevalent and a leading cause of pain that limits physical functioning in older adults. Clinical practice guidelines recommend physical exercise for managing symptoms of knee OA. As a result, several evidence-based exercise programs have been implemented in community centers. However, access to these programs is severely limited in rural settings. Considering that rural communities have a higher disease burden and higher proportion of older adults than non-rural areas, there is a critical need to (1) adapt evidence-based exercise programs for remote delivery to increase access for rural older adults and (2) develop pathways to implement exercise programs in rural health care systems that consistently reach and engage patients with knee OA. Accordingly, we aim to engage rural primary care practices (including medical directors, clinicians, and staff) to develop a clinical pathway that refers patients to an evidence-based exercise program, called Enhance Fitness® (EF), which we have adapted for remote delivery (tele-EF). Enhance Fitness is a group exercise program that is recommended by the CDC for OA management. It is available in over 800 sites nationally and is covered by Medicare Advantage plans, but it is generally not available in rural communities. In addition, we will assess the feasibility and acceptability of implementing the clinical pathway that identifies physically inactive older patients with knee OA, facilitates exercise prescription, and streamlines referral to tele-EF in a rural primary care clinic over a 5-month period.

Conditions

Knee Osteoarthritis

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Tele-EF

Tele-EnhanceFitness

Group Type: EXPERIMENTAL

Tele-EnhanceFitness

Intervention Type: BEHAVIORAL

Livestream, instructor-led tele-exercise classes, involving balance, endurance, and strength training

Interventions

Tele-EnhanceFitness

Livestream, instructor-led tele-exercise classes, involving balance, endurance, and strength training

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• Age ≥65 years
• Community-dwelling
• English-speaking
• Physician diagnosed knee osteoarthritis
• Physically inactive as determined by the 2-item Physical Activity Vital Sign questionnaire

Exclusion Criteria

• Cognitive impairment determined by a Mini Montreal Cognitive Assessment score of <11
• Significant, non-corrected visual or hearing impairment
• Plans to move out of the area in the next 6 months
• Cancer requiring treatment (except for non-melanoma skin cancer) in the past 6 months
• Heart attack in the past 6 months
• Stroke in the past 6 months
• Hip fracture in the past 6 months
• Hip/knee replacement in the past 6 months
• Spinal surgery in the past 6 months
• Heart surgery in the past 6 months
• Deep vein thrombosis in the past 6 months
• Pulmonary embolus in the past 6 months
• Hospitalization within the last month
• ≥3 falls within the past month

• Minimum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University of Washington

OTHER

Sponsor Role: lead

Responsible Party

Kushang Patel

Research Associate Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Kushang V Patel, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Washington

Locations

University of Washington

Seattle, Washington, United States

Countries

United States

Central Contacts

Kushang V Patel, PhD

Role: CONTACT

kvpatel@uw.edu

2066168052

Elise V Hoffman, BS

Role: CONTACT

evh3@uw.edu

2066164671

Other Identifiers

STUDY00012144

Identifier Type: -

Identifier Source: org_study_id