Group-mediated physical activity promotion and mobility in sedentary patients with knee osteoarthritis: results from the IMPACT-pilot trial

J Rheumatol. 2014 Oct;41(10):2068-77. doi: 10.3899/jrheum.140054. Epub 2014 Sep 1.

Abstract

Objective: To compare the effects of a group-mediated cognitive behavioral exercise intervention (GMCB) with traditional center-based exercise therapy (TRAD) on objectively assessed levels of physical activity (PA) and mobility in sedentary patients with knee osteoarthritis (OA).

Methods: The Improving Maintenance of Physical Activity in Knee Osteoarthritis Trial-Pilot (IMPACT-P) was a 12-month, 2-arm, single-blind, randomized controlled pilot study designed to compare the effects of GMCB and TRAD on 80 sedentary patients with knee OA with self-reported difficulty in daily activities [mean age 63.5 yrs, 84% women, mean body mass index (BMI) 32.7 kg/m(2)]. Objective assessments of PA (LIFECORDER Plus Accelerometer) and mobility (400-m walk) were obtained at baseline, 3 months, and 12 months by study personnel blinded to participants' treatment assignment.

Results: Intent to treat 2 (treatment: GMCB and TRAD) × 2 (time: 3 mos and 12 mos) analyses of covariance of controlling for baseline, age, sex, and BMI-adjusted change in the outcomes demonstrated that the GMCB intervention yielded significantly greater increases in PA (p < 0.01) and a nonsignificant yet more favorable improvement in mobility (p = 0.09) relative to TRAD. Partial correlation analyses also revealed that change in PA was significantly correlated with the 400-m walk performance at 3-month (r = -0.51, p < 0.01) and 12-month (r = -0.40, p < 0.01) followup assessments.

Conclusion: Findings from the IMPACT-P trial suggest that the GMCB treatment resulted in significantly greater improvement in PA and nonsignificant yet more favorable change in mobility relative to TRAD.

Keywords: AGING; EXERCISE; MOBILITY; OSTEOARTHRITIS; PHYSICAL ACTIVITY.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Body Mass Index
  • Exercise Therapy*
  • Female
  • Health Promotion*
  • Humans
  • Male
  • Middle Aged
  • Motor Activity*
  • Osteoarthritis, Knee / rehabilitation*
  • Pilot Projects
  • Single-Blind Method
  • Treatment Outcome
  • Walking*