Osteoarthritis, KneeNCT04049318
Effects of a Structured Digital Osteoarthritis Self-management Program After 6 Months of Adherence
An observational study of Osteoarthritis, Knee and Osteoarthritis, Hip, run by Lund University at 1 site in Sweden.
Trial summary
This is a study based on a cohort in a register of patients enrolled in a digital osteoarthritis self-management program, Joint Academy. The purpose of this study is to examine joint pain and the potential change of this pain, in patients with long-term adherence to a digital self-management program for individuals… Read more about this study
- Who is it for?
- Any age
- Conditions the study is for
- Osteoarthritis, Knee, Osteoarthritis, Hip
- What is being tested?
- Education+ exercise (delivered digitally)
- How many people
- 1,709 participants
- Where
- 1 siteSweden
- Study dates
- 14 Mar 2019to 14 Mar 2019
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- Child, Adult, Older adult
Study population: At the time of the study start (13th of March, 2019), the Joint Academy patient database contained data from 1709 Swedish participants who had reported one of their knees or hips as their most symptomatic joint
Who may be able to join
- radiographic or clinical diagnosis of hip or knee OA (about 95%) from a physical therapist or physician
- had been treated in the digital non-surgical treatment program the first 3 weeks with a adherence of at least 70%
- had been included in the program at least 24 weeks prior to the data extraction
Who cannot join
- -
Trial locations and contacts
1 site in 1 country.
About this study
This is a study based on a cohort in a register of patients enrolled in a digital osteoarthritis self-management program, Joint Academy. The purpose of this study is to examine joint pain and the potential change of this pain, in patients with long-term adherence to a digital self-management program for individuals with knee- and hip osteoarthritis. The hypothesis, based on preliminary findings is that pain levels of those adhering to the program, decreases over time. To test the hypothesis, participants weekly pain report will be investigated whilst adhering to the digital program for 6- to 12 months, and statistically tests will be performed to find out whether significant differences can be seen over time.
Read the detailed description
Introduction Osteoarthritis (OA) is highly prevalent in older adults and a growing cause of disability. The importance of availability of primary treatment of OA is gaining momentum, and web-based self-management programs have in recent years become available. Evidence of short term effects of such programs are abundant, yet the evaluation of long term effects of these programs is scarce.
Aim To investigate joint pain development over time from participation in a web-based OA self-management program for people with hip or knee OA.
Methods Participants joined the program through advertisements and campaigns on the web. Included participants had a radiographic or clinical diagnosis of hip or knee OA (about 95%) from a physical therapist or physician. The intervention consisted of a digital, structured and individualized treatment program for people with hip or knee OA (Joint Academy®; www.jointacademy.com). The program consists of neuromuscular exercises appropriately adjusted to each patient in regard to degrees of complexity and difficulty and information in the form of text or video lessons (with quizzes on the material after each episode) on subjects related to OA, OA symptoms and its management.
Outcome measures Joint pain in the hip or knee was assessed at baseline, and weeks 12, 24 and 48 using the Numerical Rating Scale (NRS), a 0-10 scale where 0 is defined as No pain and 10 is defined as Maximum pain. Minimal clinically important change (MCIC) of pain was defined as an improvement of 20%. As a measure of physical function, the 30-second chair stand test (30CST) was used and performed by the patient every other week, using an instruction video with a coupled visual timer. The patient entered the performed number of repetitions after each test. Physical function data was handled similarly to the NRS, with week 24 ±4 adjacent weeks and week 48±6 adjacent weeks included for those with available NRS data. All outcomes were self-assessed, self-centred, and chosen based on the International Consortium for Health Outcomes Measurement Standard Set for Hip \& Knee Osteoarthritis (ICHOM).
Statistical analysis Summary data are described by the mean value, standard deviation and number of observations or the number and percent of the categories of interest. The group-specific mean treatment effect of duration on pain and repetitions (30CST - physical function), as well as differences in pain over time between hip and knee OA with or without additional covariates, were estimated and tested using random slopes and intercepts models. Pain development over time was plotted for hip and knee OA respectively.
To describe patients adhering for six months with contrasting pain severity at baseline, participants were divided into same-sized tertiles based on reported baseline pain, with related descriptive data. Mean pain per time point was calculated and plotted for each group. Significance level was set to p<0.05, and p-values and 95% confidence intervals were reported when applicable. Statistical calculations were performed in Statistical Package for Social Sciences (SPSS Version 25, IBM Corporation, New York, USA) and Stata 15.1 (StataCorp LLC, Texas, USA).
- Conditions
- Osteoarthritis, Knee, Osteoarthritis, Hip
- Being tested
- Education+ exercise (delivered digitally)
- Keywords
- Exercise, Education, Digital treatment
- Medical subject headings
- Osteoarthritis, Knee, Osteoarthritis, Hip, Motor Activity
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Education+ exercise (delivered digitally)Other
The intervention consisted of a digital, structured and individualized treatment program for people with hip or knee OA (Joint Academy®; www.jointacademy.com). The program consists of neuromuscular exercises appropriately adjusted to each patient in regard to degrees of complexity and difficulty, continuous access to and dialogue with a physiotherapist through a chat function, and/or telephone , and information in the form of text or video lessons (with quizzes on the material after each episode) on subjects related to OA, OA symptoms and its management.
| Study group | Role | What they receive |
|---|---|---|
| 24 weeks | Subjects who participated in the intervention who have data available at week 24 Receives: Other: Education+ exercise (delivered digitally) | |
| 48 weeks | Subjects who participated in the intervention who have data available at week 48 Receives: Other: Education+ exercise (delivered digitally) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in NRS pain
0 no pain, 10 max pain
Measured: 0-24 and 0-48 weeks
Change in 30 second chair stand test (30CST)
sit to stand repetitions in 30 seconds
Measured: 0-24 and 0-48 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 Aug 2019
- Study start14 Mar 2019
- Primary completion14 Mar 2019
- Study completion14 Mar 2019
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for Osteoarthritis, KneeStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 1,709 participants (actual)
Sponsor and investigators
- Lead sponsor
- Lund University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Håkan Nero, PhD, Principal investigator, Lund University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04049318
- Sponsor's protocol ID
- X
- Status last verified
- Aug 2019
- First submitted
- 5 Aug 2019
- Last updated
- 8 Aug 2019
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Thorstensson CA, Garellick G, Rystedt H, Dahlberg LE. Better Management of Patients with Osteoarthritis: Development and Nationwide Implementation of an Evidence-Based Supported Osteoarthritis Self-Management Programme. Musculoskeletal Care. 2015 Jun;13(2):67-75. doi: 10.1002/msc.1085. Epub 2014 Oct 24.
PubMed 25345913Cronstrom A, Dahlberg LE, Nero H, Ericson J, Hammarlund CS. 'I would never have done it if it hadn't been digital': a qualitative study on patients' experiences of a digital management programme for hip and knee osteoarthritis in Sweden. BMJ Open. 2019 May 24;9(5):e028388. doi: 10.1136/bmjopen-2018-028388.
PubMed 31129601Nero H, Ranstam J, Kiadaliri AA, Dahlberg LE. Evaluation of a digital platform for osteoarthritis treatment: study protocol for a randomised clinical study. BMJ Open. 2018 Nov 8;8(11):e022925. doi: 10.1136/bmjopen-2018-022925.
PubMed 30413507Nero H, Dahlberg J, Dahlberg LE. A 6-Week Web-Based Osteoarthritis Treatment Program: Observational Quasi-Experimental Study. J Med Internet Res. 2017 Dec 18;19(12):e422. doi: 10.2196/jmir.9255.
PubMed 29254906Cronstrom A, Nero H, Dahlberg LE. Factors Associated With Patients' Willingness to Consider Joint Surgery After Completion of a Digital Osteoarthritis Treatment Program: A Prospective Cohort Study. Arthritis Care Res (Hoboken). 2019 Sep;71(9):1194-1201. doi: 10.1002/acr.23772. Epub 2019 Jul 17.
PubMed 30298990
Study at a glance
From the registry record, last updated by the sponsor on 8 Aug 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of a Structured Digital Osteoarthritis Self-management Program After 6 Months of Adherence
- ClinicalTrials.gov ID
- NCT04049318
- Acronym / sponsor ID
- X
- Conditions
- Osteoarthritis, Knee, Osteoarthritis, Hip
- Keywords
- Exercise, Education, Digital treatment
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 1,709 participants (actual)
- Lead sponsor
- Lund UniversityUniversity, hospital or other
- Study start
- 14 Mar 2019 (actual)
- Primary completion
- 14 Mar 2019 (actual)
- Study completion
- 14 Mar 2019 (actual)
- First posted
- 8 Aug 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a study based on a cohort in a register of patients enrolled in a digital osteoarthritis self-management program, Joint Academy. The purpose of this study is to examine joint pain and the potential change of this pain, in patients with long-term adherence to a digital self-management program for individuals with knee- and hip osteoarthritis. The hypothesis, based on preliminary findings is that pain levels of those adhering to the program, decreases over time. To test the hypothesis, participants weekly pain report will be investigated whilst adhering to the digital program for 6- to 12 months, and statistically tests will be performed to find out whether significant differences can be seen over time.
Detailed description
Introduction Osteoarthritis (OA) is highly prevalent in older adults and a growing cause of disability. The importance of availability of primary treatment of OA is gaining momentum, and web-based self-management programs have in recent years become available. Evidence of short term effects of such programs are abundant, yet the evaluation of long term effects of these programs is scarce.
Aim To investigate joint pain development over time from participation in a web-based OA self-management program for people with hip or knee OA.
Methods Participants joined the program through advertisements and campaigns on the web. Included participants had a radiographic or clinical diagnosis of hip or knee OA (about 95%) from a physical therapist or physician. The intervention consisted of a digital, structured and individualized treatment program for people with hip or knee OA (Joint Academy®; www.jointacademy.com). The program consists of neuromuscular exercises appropriately adjusted to each patient in regard to degrees of complexity and difficulty and information in the form of text or video lessons (with quizzes on the material after each episode) on subjects related to OA, OA symptoms and its management.
Outcome measures Joint pain in the hip or knee was assessed at baseline, and weeks 12, 24 and 48 using the Numerical Rating Scale (NRS), a 0-10 scale where 0 is defined as No pain and 10 is defined as Maximum pain. Minimal clinically important change (MCIC) of pain was defined as an improvement of 20%. As a measure of physical function, the 30-second chair stand test (30CST) was used and performed by the patient every other week, using an instruction video with a coupled visual timer. The patient entered the performed number of repetitions after each test. Physical function data was handled similarly to the NRS, with week 24 ±4 adjacent weeks and week 48±6 adjacent weeks included for those with available NRS data. All outcomes were self-assessed, self-centred, and chosen based on the International Consortium for Health Outcomes Measurement Standard Set for Hip \& Knee Osteoarthritis (ICHOM).
Statistical analysis Summary data are described by the mean value, standard deviation and number of observations or the number and percent of the categories of interest. The group-specific mean treatment effect of duration on pain and repetitions (30CST - physical function), as well as differences in pain over time between hip and knee OA with or without additional covariates, were estimated and tested using random slopes and intercepts models. Pain development over time was plotted for hip and knee OA respectively.
To describe patients adhering for six months with contrasting pain severity at baseline, participants were divided into same-sized tertiles based on reported baseline pain, with related descriptive data. Mean pain per time point was calculated and plotted for each group. Significance level was set to p<0.05, and p-values and 95% confidence intervals were reported when applicable. Statistical calculations were performed in Statistical Package for Social Sciences (SPSS Version 25, IBM Corporation, New York, USA) and Stata 15.1 (StataCorp LLC, Texas, USA).
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| 24 weeks | – | Other: Education+ exercise (delivered digitally)Subjects who participated in the intervention who have data available at week 24 |
| 48 weeks | – | Other: Education+ exercise (delivered digitally)Subjects who participated in the intervention who have data available at week 48 |
Who may qualify
- Sex
- All
- Age groups
- Child, Adult, Older adult
- Study population
- At the time of the study start (13th of March, 2019), the Joint Academy patient database contained data from 1709 Swedish participants who had reported one of their knees or hips as their most symptomatic joint
Key inclusion criteria (3 listed)
- radiographic or clinical diagnosis of hip or knee OA (about 95%) from a physical therapist or physician
- had been treated in the digital non-surgical treatment program the first 3 weeks with a adherence of at least 70%
- had been included in the program at least 24 weeks prior to the data extraction
Key exclusion criteria (1 listed)
- -
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Education+ exercise (delivered digitally)The intervention consisted of a digital, structured and individualized treatment program for people with hip or knee OA (Joint Academy®; www.jointacademy.com). The program consists of neuromuscular exercises appropriately adjusted to each patient in regard to degrees of complexity and difficulty, continuous access to and dialogue with a physiotherapist through a chat function, and/or telephone , and information in the form of text or video lessons (with quizzes on the material after each episode) on subjects related to OA, OA symptoms and its management. | Other | 24 weeks, 48 weeks |
Primary outcome
Change in NRS pain
Time frame: 0-24 and 0-48 weeks
0 no pain, 10 max pain
Change in 30 second chair stand test (30CST)
Time frame: 0-24 and 0-48 weeks
sit to stand repetitions in 30 seconds
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Aug 2019.
- Background: PubMed 25345913Thorstensson CA, Garellick G, Rystedt H, Dahlberg LE. Better Management of Patients with Osteoarthritis: Development and Nationwide Implementation of an Evidence-Based Supported Osteoarthritis Self-Management Programme. Musculoskeletal Care. 2015 Jun;13(2):67-75. doi: 10.1002/msc.1085. Epub 2014 Oct 24.
- Background: PubMed 31129601Cronstrom A, Dahlberg LE, Nero H, Ericson J, Hammarlund CS. 'I would never have done it if it hadn't been digital': a qualitative study on patients' experiences of a digital management programme for hip and knee osteoarthritis in Sweden. BMJ Open. 2019 May 24;9(5):e028388. doi: 10.1136/bmjopen-2018-028388.
- Background: PubMed 30413507Nero H, Ranstam J, Kiadaliri AA, Dahlberg LE. Evaluation of a digital platform for osteoarthritis treatment: study protocol for a randomised clinical study. BMJ Open. 2018 Nov 8;8(11):e022925. doi: 10.1136/bmjopen-2018-022925.
- Background: PubMed 29254906Nero H, Dahlberg J, Dahlberg LE. A 6-Week Web-Based Osteoarthritis Treatment Program: Observational Quasi-Experimental Study. J Med Internet Res. 2017 Dec 18;19(12):e422. doi: 10.2196/jmir.9255.
- Background: PubMed 30298990Cronstrom A, Nero H, Dahlberg LE. Factors Associated With Patients' Willingness to Consider Joint Surgery After Completion of a Digital Osteoarthritis Treatment Program: A Prospective Cohort Study. Arthritis Care Res (Hoboken). 2019 Sep;71(9):1194-1201. doi: 10.1002/acr.23772. Epub 2019 Jul 17.
- Individual participant dataSharing planned: No
Related trials for Osteoarthritis, Knee
Not yet recruiting
Opioid Reduction and Enhanced Recovery in Orthopaedic Surgery (OREOS)-Knee
Knee Arthroplasty, Total, Partial Knee Arthroplasty
Active, not recruiting
SakuraBead Used as Resorbable Embolic for Genicular Artery Embolization
Osteo Arthritis Knee, Joint Diseases
RecruitingPhase 2
Genicular Artery Embolization for Reducing Pain in Medically Refractory Symptomatic Knee Osteoarthritis
Knee Osteoarthritis, Knee Osteoarthritis (Knee OA)
Not yet recruiting
Comparison of High-Intensity and Conventional Physical Therapy in Musculoskeletal Disorders
Low Back Pain, Radicular Syndrome
Recruiting
The Effect of Different Exercise Training Programs on Muscle Oxygenation in Individuals With Knee Osteoarthritis
Osteoarthritis of Knee
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Håkan Nero, PhD principal investigator
Lund University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Osteoarthritis, Knee and Osteoarthritis, Hip, run by Lund University at 1 site in Sweden.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 8 Aug 2019. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in NRS pain (time frame: 0-24 and 0-48 weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04049318, which also lists 5 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Aug 2019.