Effects of a 12-Week Multifaceted Wearable-Based Program for People with Knee Osteoarthritis : Randomized Controlled Trial

Li, L.C. and Feehan, L.M. and Xie, H. and Lu, N. and Shaw, C.D. and Gromala, D. and Zhu, S. and Aviña-Zubieta, J.A. and Hoens, A.M. and Koehn, C. and Tam, J. and Therrien, S. and Townsend, A.F. and Noonan, G. and Backman, C.L. (2020) Effects of a 12-Week Multifaceted Wearable-Based Program for People with Knee Osteoarthritis : Randomized Controlled Trial. JMIR mHealth and uHealth, 8 (7): e19116. ISSN 2291-5222

Abstract

Background: Current guidelines emphasize an active lifestyle in the management of knee osteoarthritis (OA), but up to 90% of patients with OA are inactive. In a previous study, we demonstrated that an 8-week physiotherapist (PT)-led counseling intervention, with the use of a Fitbit, improved step count and quality of life in patients with knee OA, compared with a control. Objective: This study aimed to examine the effect of a 12-week, multifaceted wearable-based program on physical activity and patient outcomes in patients with knee OA. Methods: This was a randomized controlled trial with a delay-control design. The immediate group (IG) received group education, a Fitbit, access to FitViz (a Fitbit-compatible app), and 4 biweekly phone calls from a PT over 8 weeks. Participants then continued using Fitbit and FitViz independently up to week 12. The delay group (DG) received a monthly electronic newsletter in weeks 1 to 12 and started the same intervention in week 14. Participants were assessed in weeks 13, 26, and 39. The primary outcome was time spent in daily moderate-to-vigorous physical activity (MVPA; in bouts ≥10 min) measured with a SenseWear Mini. Secondary outcomes included daily steps, time spent in purposeful activity and sedentary behavior, Knee Injury and OA Outcome Score, Patient Health Questionnaire-9, Partners in Health Scale, Theory of Planned Behavior Questionnaire, and Self-Reported Habit Index. Results: We enrolled 51 participants (IG: n=26 and DG: n=25). Compared with the IG, the DG accumulated significantly more MVPA time at baseline. The adjusted mean difference in MVPA was 13.1 min per day (95% CI 1.6 to 24.5). A significant effect was also found in the adjusted mean difference in perceived sitting habit at work (0.7; 95% CI 0.2 to 1.2) and during leisure activities (0.7; 95% CI 0.2 to 1.2). No significant effect was found in the remaining secondary outcomes. Conclusions: A 12-week multifaceted program with the use of a wearable device, an app, and PT counseling improved physical activity in people with knee OA.