Telehealth Exercise Program for Arthritis
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: VA Office of Research and Development
Disqualifiers: Recent surgery, Cardiovascular event, Mental health, Terminal illness, Motor neuron diseases, others
No Placebo Group
Approved in 1 Jurisdiction
Trial Summary
What is the purpose of this trial?The goal of this study is to evaluate the acceptability and feasibility of a group telehealth exercise program for Veterans with lower extremity osteoarthritis (OA). Methods: This is a randomized pilot trial where Veterans (n=50) receive a group telehealth exercise program (3 months), followed by an exercise maintenance phase (6 months) that includes either text messaging alone or text messaging plus group telehealth exercise booster sessions. The primary outcomes for this study are feasibility and acceptability of the intervention. Feasibility will be assessed through number and source of referrals, recruitment, and retention. Acceptability will be assessed through surveys and interviews for participants and providers addressing reasons for participation, satisfaction, perceived appropriateness, and overall experience containing Likert scales and both yes/no and open-ended questions. Exploratory outcomes, assessed at multiple time points during the course of the study, will measure changes in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and changes in performance measure and physical activity assessed remotely through individual telehealth sessions. Data will be collected at baseline, 3-, 6-, and 9-month follow-up.
Do I need to stop my current medications to join the trial?
The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the study team or your primary care physician.
What data supports the effectiveness of the Telehealth Exercise Program for Arthritis treatment?
Research shows that telehealth exercise programs, like those used for knee osteoarthritis and older adults, can improve physical function and are as effective as in-person sessions. Participants also reported benefits such as improved balance and high attendance rates, indicating that virtual exercise therapy can be a viable option for managing arthritis.
12345Is the Telehealth Exercise Program safe for humans?
Research on telehealth exercise programs, including those for older adults, shows they are generally safe and can improve physical function without significant differences compared to in-person sessions. Participants in these programs have reported positive experiences and benefits such as improved balance.
25678How is the Telehealth Exercise Program for Arthritis different from other treatments?
The Telehealth Exercise Program for Arthritis is unique because it allows patients to participate in group exercise sessions from home using live video, which can improve physical function and maintain high attendance rates, similar to in-person sessions, but with the added convenience of remote access.
125910Eligibility Criteria
This trial is for Veterans with knee or hip arthritis who are patients at Eastern Colorado Healthcare System, haven't been active lately, and have had a VA visit in the past year. It's not for those without phone access, recent serious health events, current participation in similar studies, or conditions that would limit joining group exercises.Inclusion Criteria
Veterans at Eastern Colorado Healthcare System Primary Care Clinics with at least one VA visit within the past year
I have been diagnosed with painful knee or hip arthritis.
Physically inactive individuals (defined as...)
Exclusion Criteria
I haven't seen a primary care doctor in the last year.
I have had hip or knee surgery, or a recent severe knee injury.
I was recently hospitalized for a heart or stroke-related event.
+9 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Exercise Initiation
Participants receive a group telehealth exercise program for 3 months
3 months
Weekly group telehealth sessions
Exercise Maintenance
Participants continue with text messaging alone or text messaging plus monthly group telehealth exercise booster sessions
6 months
Monthly group telehealth sessions for booster group
Follow-up
Participants are monitored for changes in physical activity and osteoarthritis symptoms
3 months
Data collection at 3-, 6-, and 9-month follow-up
Participant Groups
The study tests a telehealth exercise program for Veterans with arthritis over 9 months. Participants will do group exercises via telehealth for 3 months followed by text message support or additional booster sessions to maintain exercise habits.
2Treatment groups
Experimental Treatment
Active Control
Group I: Exercise Initiation and Maintenance with Text Messaging and Booster SessionsExperimental Treatment1 Intervention
Participants receive 3 months of group telehealth exercise initiation plus text messaging followed by 6 months of text messaging plus monthly group telehealth exercise booster sessions.
Group II: Exercise Initiation and Maintenance with Text Messaging aloneActive Control1 Intervention
Participants receive 3 months of group telehealth exercise initiation plus text messaging followed by 6 months of text messaging alone.
Group Telehealth Exercise Sessions is already approved in United States for the following indications:
🇺🇸 Approved in United States as Group Telehealth Exercise Sessions for:
- Lower extremity osteoarthritis (OA)
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Rocky Mountain Regional VA Medical Center, Aurora, COAurora, CO
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Who Is Running the Clinical Trial?
VA Office of Research and DevelopmentLead Sponsor
References
"Much better than I thought it was going to be": Telehealth delivered group-based education and exercise was perceived as acceptable among people with knee osteoarthritis. [2022]To understand patient perceived acceptability of participating in a telehealth delivered group-based education and exercise-therapy program for knee osteoarthritis.
Physical Function Effects of Live Video Group Exercise Interventions for Older Adults: A Systematic Review and Veteran's Gerofit Group Case Study. [2023]Background: Literature on telehealth interventions for older adults has been primarily on asynchronous interventions. During the COVID-19 pandemic, older adult exercise programs transitioned to an online format. This systematic review and case study examines the effectiveness of older adult live video exercise group interventions on physical health with insights from a Los Angeles VA program, Gerofit. Methods: PubMed was searched for live video older adult exercise groups from database inception to November 2021. All eligible studies included assessments of physical health and were limited to participants with an average age of 65 years or greater. Ten Veterans, who had participated in both in-person and virtual Gerofit sessions, were surveyed in the case study. Results: Nine studies met the inclusion criteria. Four studies included an equivalent in-person group as a comparator to the live video group and reported no significant between-group differences in outcomes, including energy expenditure and 6-minute walking distance test (6MWD). The other five studies reported statistically significant in-group improvement in outcomes including isokinetic knee strength. Case study participants reported similar attendance rates and perceived benefits, such as improved balance, when comparing virtual and in-person sessions. Discussion: Live video exercise groups in older adults demonstrated an improvement in physical function that was not statistically different from the comparison in-person sessions with the added benefit of averaging a higher attendance rate, providing initial support for the use of live video in older adult exercise programs. Insights from the case study supplement this by demonstrating older adults' positive attitude on these groups.
Level of participation in physical therapy or an internet-based exercise training program: associations with outcomes for patients with knee osteoarthritis. [2019]To examine whether number of physical therapy (PT) visits or amount of use of an internet-based exercise training (IBET) program is associated with differential improvement in outcomes for participants with knee osteoarthritis (OA).
How Does Exercise, With and Without Diet, Improve Pain and Function in Knee Osteoarthritis? A Secondary Analysis of a Randomized Controlled Trial Exploring Potential Mediators of Effects. [2023]To explore the mediators of effects of two 6-month telehealth-delivered exercise programs, including exercise with and without weight-loss diet, on pain and function improvements in knee osteoarthritis (OA).
Rapid Transition to Telehealth Group Exercise and Functional Assessments in Response to COVID-19. [2021]Exercise is critical for health maintenance in late life. The COVID-19 shelter in place and social distancing orders resulted in wide-scale interruptions of exercise therapies, placing older adults at risk for the consequences of decreased mobilization. The purpose of this paper is to describe rapid transition of the Gerofit facility-based group exercise program to telehealth delivery. This Gerofit-to-Home (GTH) program continued with group-based synchronous exercise classes that ranged from 1 to 24 Veterans per class and 1 to 9 classes offered per week in the different locations. Three hundred and eight of 1149 (27%) Veterans active in the Gerofit facility-based programs made the transition to the telehealth delivered classes. Participants' physical performance testing continued remotely as scheduled with comparisons between most recent facility-based and remote testing suggesting that participants retained physical function. Detailed protocols for remote physical performance testing and sample exercise routines are described. Translation to remote delivery of exercise programs for older adults could mitigate negative health effects.
When More Than Exercise Is Needed to Increase Chances of Aging in Place: Qualitative Analysis of a Telehealth Physical Activity Program to Improve Mobility in Low-Income Older Adults. [2020]A telehealth-delivered physical activity program was implemented within two low-income older adult housing properties utilizing the Otago exercise program, a physical therapy program endorsed by the Centers for Disease Control and Prevention to improve balance and strengthening in community dwelling older adults and by the National Council on Aging as the highest level of evidence for fall prevention programs. Participants were also given Fitbit activity monitors to help track their activity.
"Participation, satisfaction, perceived benefits, and maintenance of behavioral self-management strategies in a self-directed exercise program for adults with arthritis". [2019]A process evaluation was conducted in conjunction with a controlled trial of a self-directed exercise program among people with arthritis to describe the program's reach; self-management behaviors, exposure to materials, program perceptions, satisfaction, and perceived benefits; compatibility with targeted participants' needs; and maintenance. Participants (n=197) were predominantly white, middle-aged, college-educated women. At 12 weeks, 73.2% had read ≥90% of the program materials (at nine months>70% had "occasionally" or "often" looked back over each of the five parts of the materials); 63.3% had set goals (52.5% at nine months), and 83.9% had "some" or "a lot" of success following their plan (64.2% at nine months), while 90.4% rated the program "good" or "excellent" (87.5% at nine months). At 12 weeks, the majority (89.3%) used written logs to self-monitor (mean=9.3 logs); by nine months, >70% never kept logs. Most (>80%) rated twelve of thirteen program components as helpful, and 98.6% would recommend the program. From 38% to 62.4% endorsed each of eight program benefits, with small declines of ≤9% at nine months. Qualitative response identified ways the program met and did not meet expectations. The main program compatibility issue was targeting all adults with arthritis, while featuring older adults in materials.
Evaluation of group and self-directed formats of the Arthritis Foundation's Walk With Ease Program. [2011]To evaluate the effects of a revised 6-week walking program for adults with arthritis, Walk With Ease (WWE), delivered in 2 formats, instructor-led group or self-directed.
Assessing exercise capacity using telehealth: a feasibility study in adults with cystic fibrosis. [2013]Provision of healthcare from a remote site may assist patients to access important services. We aimed to establish the feasibility of monitoring an assessment of exercise capacity using telehealth technology.
Providing Rural Veterans With Access to Exercise Through Gerofit. [2020]Clinical video telehealth can be used to deliver functional circuit exercise training to older veterans in remote locations.