Mobility Optimization Through Velocity Exercise (MOVE)
Knee Osteoarthritis (OA) accounts for a significant proportion of mobility limitations and is one of the most disabling problems facing the growing population of older adults. The purpose of this research is to reduce disablement of older adults with symptomatic knee osteoarthritis.
Other: Gait Training
Other: Power Training
|Study Design:||Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
|Official Title:||Optimizing Mobility in Older Adults With Knee Osteoarthritis|
- Advanced Lower Limb Function: Late Life Function and Disability Instrument [ Time Frame: 1,3,6, and 12 months ] [ Designated as safety issue: No ]
- Impairment: knee pain, stair climb power [ Time Frame: 0,3,6 and 12 months ] [ Designated as safety issue: No ]
- Functional limitation: timed stair climb, summary performance score, long distance corridor walk [ Time Frame: 0,3,6 and 12 months ] [ Designated as safety issue: No ]
- Knee-Related Quality of Life [ Time Frame: 0,3,6 and 12 months ] [ Designated as safety issue: No ]
|Study Start Date:||August 2008|
|Estimated Study Completion Date:||June 2012|
|Primary Completion Date:||October 2010 (Final data collection date for primary outcome measure)|
Gait Training Arm
Other: Gait Training
Gait training with a physical therapist 2/week for the first 3 months followed by 1/week for the following 3 months
Power Training Arm
Other: Power Training
Power exercise training with an exercise specialist 2/week for 3 months, followed by by training with the exercise specialist 1/week and training at home 1/week for 3 months
Placebo Comparator: Control
There is no intervention associated with this arm of the study
The long-term objective of this research is to reduce disablement of older adults with knee osteoarthritis (OA). This will be accomplished through assessing changes in functional limitations (standing and walking) that occur with 2 mobility-specific interventions. The principle of specificity of training indicates that exercises that closely approximate the goal functional activity are most effective in improving physical performance during that activity. However, there is uncertainty whether intervening to increase muscle power or to improve gait mechanics would be most effective for optimizing mobility in older adults with knee OA. Although gait training may be most specific for improving gait, this approach currently requires supervised physical therapy and expensive equipment. In contrast, power training may be less costly and more convenient if conducted at home. To optimize mobility in older adults with symptomatic knee OA, there is a need to study each of these mobility-specific interventions in a randomized controlled trial (RCT). Successful completion of this trial will inform rehabilitation for maintaining or improving mobility as well as explore the mechanism of effect.
Specific Aim 1: Assess the efficacy of two innovative interventions for improving mobility limitations, disability and quality of life in older adults with symptomatic knee OA.
Primary Hypothesis: For older adults with symptomatic knee OA, in comparison with usual care (control group), a 3-month a) patient-specific gait training intervention and b) mobility-specific power training intervention will reduce lower limb mobility limitations assessed using the Function component of the Late Life Function and Disability Index (LLFDI-Function).
Hypothesis 2: Improved mobility will be maintained at 6 and 12-month follow-up (3 and 9 months following transitioning to home-based training) for each of the 2 intervention groups who receive the combination of the home-based intervention and encouragement to continue participation.
Hypothesis 3: In comparison to baseline measures, at 3, 6, and 12-month follow-up, each of the 2 intervention groups will demonstrate improvements in a) disability (LDCW), b) quality of life assessed using the Knee Osteoarthritis Outcome Score questionnaire Quality of Life component(KOOS Knee QOL), and c) knee OA specific outcome scores using the pain subscale component of KOOS.
|United States, Iowa|
|University of Iowa|
|Iowa City, Iowa, United States, 52242|
|Principal Investigator:||Neil A Segal, MD, MS||University of Iowa|