336 Participants Needed

Remote Exercise Program for Knee Replacement

(MOST Energized Trial)

JN
CP
Overseen ByChristine Pellegrini, PhD
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: University of South Carolina
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It mainly focuses on your physical activity and knee replacement history.

What data supports the effectiveness of the treatment 'Hear from Others' Videos, Individualized Feedback, Online exercise program, Phone Coaching, Progress reports to providers for knee replacement?

Research shows that structured telephone follow-up can improve patient compliance with home exercises after knee replacement, and using patient-reported outcome measures (PROMs) can enhance treatment outcomes by providing valuable feedback to both patients and providers. These elements suggest that the components of the remote exercise program, such as phone coaching and progress reports, may be effective in improving recovery after knee replacement.12345

Is the remote exercise program for knee replacement safe for humans?

Research shows that home-based exercise programs, including digital coaching and smartphone-based systems, are generally safe for people after knee replacement surgery, as they are not inferior to traditional in-person therapy.678910

How is the 'Remote Exercise Program for Knee Replacement' treatment different from other treatments for knee replacement recovery?

This treatment is unique because it combines 'Hear from Others' videos, individualized feedback, an online exercise program, phone coaching, and progress reports to providers, which together aim to enhance adherence and improve recovery. Unlike traditional supervised programs, this approach leverages remote and digital tools to support patients in their home environment, potentially increasing convenience and engagement.39111213

What is the purpose of this trial?

The purpose of this study is to identify which supplemental intervention components added to an online exercise program contribute to the greatest increases in physical activity (total MVPA and percent meeting guidelines \[≥150 min/week of MVPA\]) in adults with knee replacement at 6 and 12 months. Secondary outcomes will examine changes in pain and physical function.

Research Team

CP

Christine Pellegrini, PhD

Principal Investigator

University of South Carolina

JU

Jessica Unick, PhD

Principal Investigator

The Miriam Hospital

Eligibility Criteria

This trial is for adults who had a knee replacement at least a year ago, are not very active (less than 60 minutes of moderate exercise per week), and can access the internet. They should be willing to try an online exercise program and additional support methods. People with health issues that limit mobility, those already in physical therapy or other programs, or planning surgery within a year cannot join.

Inclusion Criteria

I had a knee replacement surgery over a year ago.
Be willing to complete the 4 remote assessments, including physical activity monitoring
Have a computer, tablet, or smartphone with active internet access
See 3 more

Exclusion Criteria

Any contraindications to physical activity (e.g., chest pain)
Are participating in a structured weight loss or physical activity program
Score >30 on PROMIS cognitive function
See 7 more

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive a 6-month, fully automated online behavioral exercise program designed to increase moderate-intensity physical activity

6 months
Weekly video lessons during months 1-3, monthly lessons during months 4-6

Follow-up

Participants are monitored for changes in physical activity, pain, and physical function

6 months

Treatment Details

Interventions

  • 'Hear from Others' Videos
  • Individualized Feedback
  • Online exercise program
  • Phone Coaching
  • Progress reports to providers
Trial Overview The study tests how well different supports like motivational videos, progress reports to doctors, phone coaching, and personalized feedback work alongside an online exercise program to help people with knee replacements become more physically active and improve their pain and function.
Participant Groups
16Treatment groups
Experimental Treatment
Group I: Experimental condition 9Experimental Treatment4 Interventions
Energize Online Program plus progress reports to physicians, 'Hear From Others' videos, and individualized feedback
Group II: Experimental condition 8Experimental Treatment2 Interventions
Energize Online Program plus phone coaching
Group III: Experimental condition 7Experimental Treatment3 Interventions
Energize Online Program plus phone coaching and individualized feedback
Group IV: Experimental condition 6Experimental Treatment3 Interventions
Energize Online Program plus phone coaching and 'Hear From Others' videos
Group V: Experimental condition 5Experimental Treatment4 Interventions
Energize Online Program plus phone coaching, 'Hear From Others' videos, and individualized feedback
Group VI: Experimental condition 4Experimental Treatment3 Interventions
Energize Online Program plus phone coaching and progress reports to physicians
Group VII: Experimental condition 3Experimental Treatment4 Interventions
Energize Online Program plus phone coaching, progress reports to physicians, and individualized feedback
Group VIII: Experimental condition 2Experimental Treatment4 Interventions
Energize Online Program plus phone coaching, progress reports to physicians, and 'Hear From Others' videos
Group IX: Experimental condition 16Experimental Treatment1 Intervention
Energize Online Program
Group X: Experimental condition 15Experimental Treatment2 Interventions
Energize Online Program plus individualized feedback
Group XI: Experimental condition 14Experimental Treatment2 Interventions
Energize Online Program plus 'Hear From Others' videos
Group XII: Experimental condition 13Experimental Treatment3 Interventions
Energize Online Program plus 'Hear From Others' videos and individualized feedback
Group XIII: Experimental condition 12Experimental Treatment2 Interventions
Energize Online Program plus progress reports to physicians
Group XIV: Experimental condition 11Experimental Treatment3 Interventions
Energize Online Program plus progress reports to physicians and individualized feedback
Group XV: Experimental condition 10Experimental Treatment3 Interventions
Energize Online Program plus progress reports to physicians and 'Hear From Others' videos
Group XVI: Experimental condition 1Experimental Treatment5 Interventions
Energize Online Program plus phone coaching, progress reports to physicians, 'Hear From Others' videos, and individualized feedback

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of South Carolina

Lead Sponsor

Trials
233
Recruited
122,000+

National Institute on Aging (NIA)

Collaborator

Trials
1,841
Recruited
28,150,000+

Findings from Research

A study involving 202 elderly patients showed that structured telephone follow-up after total knee arthroplasty (TKA) significantly increased home-exercise compliance compared to routine care.
Both groups experienced improvements in pain, functional ability, and quality of life after TKA, but the intervention group showed greater enhancements in mental health and active range of motion.
Influence of structured telephone follow-up on patient compliance with rehabilitation after total knee arthroplasty.Chen, M., Li, P., Lin, F.[2020]
Patient-reported outcome measures (PROMs) are becoming essential in total knee arthroplasty as they help improve patient outcomes and align with the shift towards value-based healthcare in the U.S.
Electronic platforms for collecting and analyzing PROMs provide real-time data that enhances shared decision-making and allows for better comparisons of care quality among different healthcare practices.
Implementation of Patient-reported Outcome Measures in Total Knee Arthroplasty.Ayers, DC.[2022]
The 'Virtual Clinic' follow-up system for hip and knee replacement patients achieved a 36% compliance rate, with 710 out of 1405 contactable patients completing the process, demonstrating its feasibility for patient monitoring.
Surgeons identified 23% of patients as needing face-to-face assessments based on their Oxford scores, leading to the detection of 14 patients requiring revision surgery, highlighting the system's effectiveness in managing post-operative care.
Two and a half years on: data and experiences establishing a 'Virtual Clinic' for joint replacement follow up.Lovelock, T., O'Brien, M., Young, I., et al.[2019]

References

Influence of structured telephone follow-up on patient compliance with rehabilitation after total knee arthroplasty. [2020]
Implementation of Patient-reported Outcome Measures in Total Knee Arthroplasty. [2022]
Two and a half years on: data and experiences establishing a 'Virtual Clinic' for joint replacement follow up. [2019]
Research Priorities for Optimal Use of Patient-reported Outcomes in Quality and Outcome Improvement for Total Knee Arthroplasty. [2017]
Outpatient physiotherapy versus home-based rehabilitation for patients at risk of poor outcomes after knee arthroplasty: CORKA RCT. [2021]
Financial Incentives and Health Coaching to Improve Physical Activity Following Total Knee Replacement: A Randomized Controlled Trial. [2020]
Reporting of post-operative rehabilitation interventions for Total knee arthroplasty: a scoping review. [2022]
2021 Mark Coventry Award: Use of a smartphone-based care platform after primary partial and total knee arthroplasty: a prospective randomized controlled trial. [2021]
The effectiveness of the use of a digital activity coaching system in addition to a two-week home-based exercise program in patients after total knee arthroplasty: study protocol for a randomized controlled trial. [2018]
Effects of a home-based, exergaming intervention on physical function and pain after total knee replacement in older adults: a randomised controlled trial. [2023]
Effectiveness of remote exercise programs in reducing pain for patients with knee osteoarthritis: A systematic review of randomized trials. [2022]
Effectiveness of an interactive virtual telerehabilitation system in patients after total knee arthoplasty: a randomized controlled trial. [2022]
A community-based exercise programme for older persons with knee pain using telemedicine. [2019]
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