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Abstract Number: 315

Efficacy of a Wearable-Enabled Physical Activity Counselling Program for People with Knee Osteoarthritis

Linda Li1, Eric C. Sayre2, Navi Grewal2, Juliane Chien2, Greg Noonan3, Ryan Falck1, John Best4, Teresa Liu-Ambrose1, Alison Hoens5, Valerie Gray6, Karen Tsui7, Wendy Watson6 and Lynne Feehan8, 1Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada, 2Arthritis Research Canada, Richmond, BC, Canada, 3Mary Pack Arthritis Program, Vancouver General Hospital, Vancouver, BC, Canada, 4University of British Columbia, vancouver, BC, Canada, 5BC SUPPORT Unit, Vancouver, BC, Canada, 6OASIS Program, Vancouver Coastal Health Authority, Vancouver, BC, Canada, 7Fraser Health Authority, Surrey, BC, Canada, 8Rehabilitation Program, Fraser Health Authority, Surrey, BC, Canada

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: Behavioral strategies, Counseling, digital technologies, Osteoarthritis and physical activity

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Session Information

Date: Sunday, November 5, 2017

Session Title: ARHP Orthopedics, Low Back Pain and Rehabilitation Poster

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Current guidelines emphasize an active lifestyle in the management of knee osteoarthritis (OA), but up to 90% of OA patients are inactive. Several modifiable risk factors are associated with low physical activity participation, including lack of motivation, doubts about effectiveness of exercise, and lack of health professional advice regarding ways to adjust their activities based on symptoms. Our study aimed to assess the efficacy of a wearable-enabled physical activity counselling program for improving activity participation and disease status in people with knee OA.

Methods: Eligible participants had a self-reported knee OA diagnosis, or symptoms of knee OA based on a validated questionnaire. After baseline assessment and randomization, the Immediate Intervention Group (II) received group education, a Fitbit, and 4 biweekly phone calls by a physiotherapist to counsel activity goals over a 2-month period. The Delayed Intervention (DI) Group received the program 2 months later. Participants were assessed at baseline (T0) and the end of 2, 4 and 6 months (T1, 2, and 3). Outcome measures included: 1) mean moderate/vigorous physical activity (MVPA) time measured with a SenseWear® monitor; 2) mean daily step count; 3) mean sedentary behaviour time; 4) Knee Injury & OA Outcome Score (KOOS). Analysis of covariance (ANCOVA) was used to evaluate the effect of the group type on the outcome measures at T1, 2, and 3, after adjusting for T0. We assessed three planned contrasts of changes: 1) compared T0–T1 between the two groups to determine if II was superior to DI (the control); 2) compared T0–T2 in II against T0–T3 in DI; 3) compared T0–T2 in II against T1–T3 in the DI. The last 2 models assessed whether the two-month delay had an impact on the effect of the intervention.

Results: In 2015–2016, we recruited 61 participants (II: n=30, 73% women; DI: n=31, 90% women). Both groups were similar in age (II: 61.3 (9.4) years; DI: 62.1 (SD 8.5)] and body mass index [II: 29.2 (5.5); DI: 29.2 (4.8)]. Figure 1 summarizes the results. Pre-specified contrast analyses revealed a significant effect whereby the II group improved in the MVPA time at T0–T1 compared to the DI (contrast coefficient: 25.2; 95% CI 5.5, 44.9; p = 0.01). A significant effect was also found in the mean daily steps at T0–T1 (contrast coefficient: 1,519; 95% CI 256.2, 2,782.3; p = 0.02). We found no significant effect in any outcome measures in the other contrast analyses.

Table 1: Results of outcome measures

Immediate Intervention Group

(n = 30)

Delayed Intervention Group

(n = 31)

T0

T1

T2

T3

T0

T1

T2

T3

Mean MVPA time [mins]

62.1 (54.6)

75.5 (54.3)

62.6 (56.3)

65.6 (48.5)

65.3 (77.4)

49.6 (46.8)

60.1 (76.8)

70.7 (71.9)

Mean daily steps

7,069.2 (3,375.3)

8,217.4 (3,095.5)

8,132.5 (3,420.7)

8,215.1 (3725.6)

7,556.6 (5,054.1)

6,713.6 (3,354.3)

7,631.9 (4,054.3)

7,573.6 (4,477.1)

Mean sedentary time [mins]

464.1 (137.7)

437.6 (133.9)

505.9 (167.2)

435.8 (138.8)

497.4 (200.7)

503.0 (160.7)

508.9 (189.0)

496.9 (179.5)

KOOS (0-100; higher = better)

Symptoms

59.8 (16.1)

62.6 (15.6)

62.4 (14.7)

62.1 (15.3)

62.9 (17.2)

61.7 (14.5)

63.4 (16.7)

61.4 (19.8)

Pain

66.2 (17.5)

70.9 (17.0)

67.5 (15.5)

68.6 (17.5)

65.1 (17.9)

64.8 (14.6)

66.3 (15.2)

66.2 (16.4)

ADL

71.8 (17.5)

76.0 (16.1)

76.6 (17.5)

75.1 (15.9)

74.1 (17.6)

71.0 (16.5)

75.2 (17.2)

73.9 (15.8)

Sports & recreation

47.3 (26.6)

49.3 (24.9)

50.0 (25.6)

50.4 (26.3)

52.7 (27.7)

47.0 (23.3)

48.9 (27.7)

49.8 (29.2)

Qol

41.0 (19.8)

47.2 (18.9)

45.4 (17.6)

44.9 (17.9)

44.6 (16.3)

42.4 (16.8)

47.5 (13.6)

48.1 (19.1)

Conclusion: Our wearable-enabled counselling program improved MVPA time and step counts in people with a diagnosis or symptoms of knee OA. The finding is important since an active lifestyle is recognized as an important component of successful self-management.


Disclosure: L. Li, None; E. C. Sayre, None; N. Grewal, None; J. Chien, None; G. Noonan, None; R. Falck, None; J. Best, None; T. Liu-Ambrose, None; A. Hoens, None; V. Gray, None; K. Tsui, None; W. Watson, None; L. Feehan, None.

To cite this abstract in AMA style:

Li L, Sayre EC, Grewal N, Chien J, Noonan G, Falck R, Best J, Liu-Ambrose T, Hoens A, Gray V, Tsui K, Watson W, Feehan L. Efficacy of a Wearable-Enabled Physical Activity Counselling Program for People with Knee Osteoarthritis [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/efficacy-of-a-wearable-enabled-physical-activity-counselling-program-for-people-with-knee-osteoarthritis/. Accessed June 2, 2023.
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