Novel uses of healthcare technology for individuals with mild to moderate hip or knee osteoarthritis: The technology, exercise and activity prescription for enhanced mobility (TEAM) study randomized controlled trial protocol

Abstract

Objectives

Patient education, physical activity, and exercise are recommended as first-line treatments for mild to moderate hip and knee osteoarthritis (OA). We developed two novel healthcare interventions: an electronic medical record-embedded physical activity prescription tool (PARx) for physicians, and a free, online educational platform (Joint Management (JM)) with exercise programming and optional telerehabilitation with a physiotherapist for patients. Objectives: 1) Determine the effectiveness of PARx ​± ​JM on patient-reported outcomes, physical activity levels, and performance-based functional outcomes in individuals with mild to moderate hip or knee OA, versus usual care; 2) evaluate engagement and adherence to PARx ​+ ​JM; and 3) explore the feasibility of PARx and PARx ​+ ​JM.

Registration

NCT04544904.

Methods

Randomized controlled trial (type 1 hybrid implementation effectiveness). We will recruit 339 (113/group) participants ≥40 years old with mild to moderate hip or knee OA and randomize them into three groups: PARx, PARx ​+ ​JM, or control (usual care). Follow-up appointments will be completed at 2-, 6-, and 12-months. Primary outcome: Knee Injury/Hip Disability and OA Outcome Score. Secondary outcomes: physical activity levels, anthropometric measurements, physical function, and other patient-reported outcomes. We will assess intervention feasibility and hold focus groups with patients and providers to explore perceptions of the interventions.

Conclusion

Two novel healthcare interventions will be used to provide physical activity and exercise programming for individuals with mild-moderate knee and hip OA. This study will allow us to determine the effectiveness of these interventions on patient-reported outcomes, physical activity levels, and performance-based functional outcomes.