Total Knee Replacement (TKR) is the most successful intervention to address pain from knee osteoarthritis. However, most resume a sedentary lifestyle gain weight and subsequently remain at high risk for poor health outcomes after surgery. There is a critical need for people after TKR to adopt an active lifestyle. Outpatient Physical therapy (PT) is an ideal, low-cost setting for a physical activity intervention for people after TKR given that physical therapists are experts at prescribing and personalizing exercises to meet patients' abilities over multiple outpatient visits. Unfortunately, little study has been devoted to the efficacy of a physical therapist delivered physical activity intervention. The objective of this proposal, which builds on significant preliminary data, is to evaluate the preliminary efficacy over 3 months of a physical therapist-delivered physical activity intervention. The intervention starts with providing a Fitbit? monitor at admission to PT. Next, the physical therapist provides face-to-face feedback on current activity levels and recommends step goals personalized to previous activity levels, a process that takes < 5 minutes at each visit. The intervention is integrated into standardized outpatient PT for TKR. Our team's long-term research goal is to test the efficacy of this innovative intervention in a future multi- center clinical trial.

Public Health Relevance

Our proposal is important from a public health perspective because we seek to promote an active lifestyle in people after Total Knee Replacement (TKR), who typically resume a sedentary lifestyle after recovery from surgery. Providing an effective intervention to promote an active lifestyle after TKR is important because of poor health consequences associated with a sedentary lifestyle and the expected burden this growing patient population will place on society. A major innovation of our proposal is that we propose to use physical therapists to deliver the intervention, who are experts at prescribing and personalizing exercises to meet patients' abilities over multiple outpatient visits.

National Institute of Health (NIH)
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Exploratory/Developmental Grants (R21)
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Arthritis and Musculoskeletal and Skin Diseases Clinical Trials Review Committee (AMSC)
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Washabaugh, Charles H
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University of Delaware
Other Health Professions
Sch Allied Health Professions
United States
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White, Daniel K; Li, Zhichang; Zhang, Yuqing et al. (2018) Physical Function After Total Knee Replacement: An Observational Study Describing Outcomes in a Small Group of Women From China and the United States. Arch Phys Med Rehabil 99:194-197
Thoma, Louise M; Dunlop, Dorothy; Song, Jing et al. (2018) Are Older Adults With Symptomatic Knee Osteoarthritis Less Active Than the General Population? Analysis From the Osteoarthritis Initiative and the National Health and Nutrition Examination Survey. Arthritis Care Res (Hoboken) 70:1448-1454
Master, Hiral; Thoma, Louise M; Christiansen, Meredith B et al. (2018) Minimum Performance on Clinical Tests of Physical Function to Predict Walking 6,000 Steps/Day in Knee Osteoarthritis: An Observational Study. Arthritis Care Res (Hoboken) 70:1005-1011
Fenton, S A M; Neogi, T; Dunlop, D et al. (2018) Does the intensity of daily walking matter for protecting against the development of a slow gait speed in people with or at high risk of knee osteoarthritis? An observational study. Osteoarthritis Cartilage 26:1181-1189
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White, Daniel K; Lee, Jungwha; Song, Jing et al. (2017) Potential Functional Benefit From Light Intensity Physical Activity in Knee Osteoarthritis. Am J Prev Med 53:689-696