Telehealth Exercise Program for Osteoarthritis

Recruiting in Palo Alto (17 mi)

Overseen byKelli Allen, PhD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: Durham VA Medical Center

No Placebo Group

Trial Summary

What is the purpose of this trial?The goal of this study is to evaluate a telehealth Stepped Exercise Program for Knee OsteoArthritis (STEP-KOA) among rural veterans. Methods: This is a single arm, pre-post pilot trial of the 6-month STEP-KOA program among rural Veterans with a physician diagnosis of knee OA who self-report knee pain ≥3 on a 0-10 scale and self-reported difficulty with either walking or stair climbing. We aim to enroll 20 Veterans in this project but may enroll up to 30 in order to obtain sufficient information to evaluate the program, particularly among Veterans who live in very rural areas. Assessments will be conducted via a combination of telephone and video at baseline and 2-, 4-, and 6-month follow-up. Assessments will include questionnaires related to pain, function and physical activity, as well as several physical performance tests. STEP-KOA begins with a low cost, primarily self-directed exercise program (supported by an internet-based tool; Step 1). Patients are then assessed for degree of improvement in symptoms, and then can step up sequentially to telephone or video-based physical activity coaching (Step 2) and physical therapy (Step 3) if they do not make clinically relevant improvements in prior steps. For this project, patients will be assessed approximately every 2 months to determine step progression. Participants will advance to the next step if they do not meet response criteria for pain and function established by the Outcome Measures in Rheumatology group and the Osteoarthritis Research Society International (OMERACT-OARSI). The Step 2 intervention involves bi-weekly telephone or video calls. Step 3 involves 3 telehealth PT visits, based on standard care for knee OA.

Eligibility Criteria

This trial is for rural veterans who use VA healthcare, have a doctor's diagnosis of knee osteoarthritis, and experience knee pain rated at least 3 out of 10 with difficulty walking or climbing stairs.

Inclusion Criteria

Rural dwelling Veterans (VA healthcare users)

I have knee pain of 3 or more and trouble walking or climbing stairs.

I have been diagnosed with knee osteoarthritis by a doctor.

Participant Groups

The study tests a telehealth Stepped Exercise Program (STEP-KOA) for managing knee osteoarthritis. It starts with self-directed exercises and progresses to coaching calls and physical therapy based on symptom improvement over six months.

1Treatment groups

Experimental Treatment

Group I: Stepped Exercise for Knee OsteoarthritisExperimental Treatment1 Intervention

Patients start with a home-based exercise program, supported by an internet-based tool (Step 1). Patients are then assessed for degree of improvement in symptoms, and then can step up sequentially to telephone or video-based physical activity coaching (Step 2) and physical therapy (Step 3) if they do not make clinically relevant improvements in prior steps.