Disability occurs when there is a gap between personal capability and the demands of a given task. Most interventions to reduce disability in older adults focus on increasing personal capability, while little is known about the effectiveness of interventions that reduce environmental demand. The long-term goal of this project is to develop and compare the effectiveness of two rehabilitation interventions (person-focused and environment-focused) in reducing disability for older adults with osteoarthritis. A single-blind randomized controlled trial will be conducted in five large publicly-subsidized senior housing sites. Eligible participants at each site will be randomly assigned to the person-focused group, environment-focused group, or control group using a random number table. The control program, designed to provide information that community-living older adults with osteoarthritis may receive without formal intervention, will consist of a two-hour lecture covering topics such as the management of pain and other osteoarthritis symptoms. The two-month treatment program will include group intervention twice a week and monthly visits from the therapist interventionist. The person-focused intervention will work to increase person capability through a progressive physical exercise program and education about positive lifestyle changes. The environment-focused intervention will work to decrease environmental barriers through demonstration and practice of techniques to facilitate activity performance and provision of assistive devices and home modifications. A comprehensive assessment will be done at baseline, immediately after the intervention, six months, and twelve months by trained assistants blind to participant group assignment.
The specific aims are to 1) to determine whether the person-focused intervention and environment-focused intervention are more effective at reducing disability than the control program and 2) to determine whether the environment-focused intervention is more effective at reducing disability than the person-focused intervention. ? ?

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
1K01HD045293-01A1
Application #
6819122
Study Section
Pediatrics Subcommittee (CHHD)
Program Officer
Nitkin, Ralph M
Project Start
2004-09-01
Project End
2009-08-31
Budget Start
2004-09-01
Budget End
2005-08-31
Support Year
1
Fiscal Year
2004
Total Cost
$100,000
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Leland, Natalie; Porell, Frank; Murphy, Susan L (2011) Does fall history influence residential adjustments? Gerontologist 51:190-200
Murphy, Susan L; Smith, Dylan M (2010) Ecological measurement of fatigue and fatigability in older adults with osteoarthritis. J Gerontol A Biol Sci Med Sci 65:184-9
Murphy, Susan L; Lyden, Angela K; Smith, Dylan M et al. (2010) Effects of a tailored activity pacing intervention on pain and fatigue for adults with osteoarthritis. Am J Occup Ther 64:869-76
Murphy, Susan L; Robinson, Jennifer C; Lin, Susan H (2009) Conducting systematic reviews to inform occupational therapy practice. Am J Occup Ther 63:363-8
Hernandez, Manuel E; Murphy, Susan L; Alexander, Neil B (2008) Characteristics of older adults with self-reported stooping, crouching, or kneeling difficulty. J Gerontol A Biol Sci Med Sci 63:759-63
Murphy, Susan L; Smith, Dylan M; Clauw, Daniel J et al. (2008) The impact of momentary pain and fatigue on physical activity in women with osteoarthritis. Arthritis Rheum 59:849-56
Murphy, Susan L; Strasburg, Debra M; Lyden, Angela K et al. (2008) Effects of activity strategy training on pain and physical activity in older adults with knee or hip osteoarthritis: a pilot study. Arthritis Rheum 59:1480-7
Murphy, Susan L; Gretebeck, Kimberlee A; Alexander, Neil B (2007) The bath environment, the bathing task, and the older adult: a review and future directions for bathing disability research. Disabil Rehabil 29:1067-75
Murphy, Susan L; Nyquist, Linda V; Strasburg, Debra M et al. (2006) Bath transfers in older adult congregate housing residents: assessing the person-environment interaction. J Am Geriatr Soc 54:1265-70