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Osteoarthritis, KneeAktiWebNCT04084834

Feasibility of a Web-based, Peer-supported Exercise Program for Patients With Hip and/or Knee Osteoarthritis

A study testing Exercise in people with Osteoarthritis, Knee and Osteoarthritis, Hip, run by Diakonhjemmet Hospital at 1 site in Norway.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

In this project, a web-based exercise program is developed in co-creation between specialized health care, the Norwegian Association for Rheumatic diseases (NRF) and a group of experienced patient representatives. Read more about this study

Who is it for?
Ages 40 to 80 years
Conditions the study is for
Osteoarthritis, Knee, Osteoarthritis, Hip
What is being tested?
Exercise
Could I receive a placebo?
No, everyone receives an active treatment
How many people
31 participants
Where
1 siteNorway
Study dates
9 Oct 2019to 1 Jun 2020
Phase
Interventional
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 40 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • patients with hip and/or knee osteoarthritis being referred to Diakonhjemmet Hospital

Who cannot join

  • candidate for surgery
  • unable to understand or write Norwegian
  • unable to walk unaided and continuously for 15 minutes
  • absolute or relative contradictions to maximal exercise testing
  • have relatives with sudden death before 40 years of age
  • have first-degree relatives with hypertrophic cardiomyopathy

Trial locations and contacts

1 site in 1 country.

Norway1 site
  • Diakonhjemmet Hospital

    Oslo, 0319

Other trials in Norway

About this study

In this project, a web-based exercise program is developed in co-creation between specialized health care, the Norwegian Association for Rheumatic diseases (NRF) and a group of experienced patient representatives. The project emerges from the evidence that exercise is recommended as first-line treatment for patients with chronic diseases like hip- and knee-osteoarthritis (OA). However, the number of patients in need of targeted exercise will increase considerably the next decades, and their treatment needs cannot be fully handled within the health care system. Development of innovative and effective treatment trajectories and follow-up strategies is urgently required. Peer-support is recognized as an effective way to increase patients' long-term adherence to exercise. Thus, patient-organizations may be an unutilized resource in support and follow-up of patients who need long-term exercise as part of their treatment plan. After discharge from examination in hospital, patients with hip/knee OA will be recruited to follow-up in a novel web-based, peer-supported exercise program, and the feasibility of the intervention will be evaluated.

Read the detailed description

The study will be conducted as a pre-post single-arm feasibility study comprising 50 participants.

The main objective of the study will be to evaluate the feasibility of the web-based, peer-supported exercise intervention in patients with hip and/or knee OA.

Specific research objectives are:

  • to assess feasibility of intervention delivery, data collection, eligibility and inclusion/exclusion criteria and intervention fidelity
  • to assess the responsiveness of relevant primary and secondary outcome measures

In the feasibility study, all participants will be allocated to an intervention group, receiving a 12-week web-based, peer-supported aerobic exercise program including weekly motivational messages. Patients between 40 and 80 years of age that are not candidates for surgery will be recruited from Diakonhjemmet Hospital, Oslo, Norway.

To assess and evaluate feasibility, we will report on descriptive statistics. Responsiveness will be assessed using Receiver Operating Curve (ROC) analyses.

Being tested
Exercise
Keywords
Exercise
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.

  • ExerciseOther

    Participants will be offered to take part in a 5-hour Learning and Mastery-course at Diakonhjemmet Hospital, receiving information about the osteoarthritis disease, symptoms and the importance of exercise and physical activity. Participants will then be given a weekly web-based exercise program (12 weeks) consisting of three aerobic exercise sessions per week. The exercise program consists of five levels, and the participants will each week be guided to the most appropriate level based on their measured physical fitness level and the weekly exercise diary. The participants will at initial assessment at Diakonhjemmet Hospital be instructed to use Borgs scale to adjust exercise level. Based on the weekly exercise diary the participants will also get motivational messages by email.

Study groups in NCT04084834
Study groupRoleWhat they receive
Intervention groupExperimentalParticipants allocated to the intervention group will be familiarized with exercise intensity levels (heart rate and Borg RPE) during the assessment at Diakonhjemmet Hospital. Further, the patients will be offered to take part in a 5-hour Learning and Mastery-course at Diakonhjemmet Hospital. Thereafter, the participants will get access to a web-based exercise program and guided to choose the appropriate exercise-level. Weekly, based on the individual progression, all participants will receive an exercise program by email consisting of individually tailored exercise sessions and motivational messages. At the end of each week, the participants complete an electronic exercise diary for monitoring adherence. All participants will be offered the possibility to seek peer-support; however, if preferred they may also follow the exercise program by themselves.
Receives: Other: Exercise

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Feasibility: time resources used by peer-supporters

    Time (hours/minutes) per participant-peer-support contact (frequency of contacts divided by total time used by peer-supporters).

    Measured: baseline to 12 weeks

  2. Feasibility: time resources used on the exercise program delivery

    Time (hours/minutes) per week per participant used on web-based exercise program delivery.

    Measured: baseline to 12 weeks

  3. Feasibility: time resources used on motivational messages delivery

    Time (hours/minutes) per week per participant used on motivational message delivery.

    Measured: baseline to 12 weeks

  4. Feasibility: proportion of received exercise diaries

    Proportion of received exercise diaries (0-12 per participant).

    Measured: baseline to 12 weeks

  5. Feasibility: proportion wearing the activity monitor

    Proportion of participants providing activity monitor data (at least 4 days, including one weekend day, with minimum 10 hours recording per day) at baseline.

    Measured: baseline

  6. Feasibility: proportion completing treadmill test

    Proportion of participants completing the indirect maximal cardiorespiratory exercise test according to test-protocol at baseline.

    Measured: baseline

  7. Eligible: proportion eligible

    Proportion of potentially eligible participants approached that are invited.

    Measured: baseline

  8. Recruitment: proportion enrolled

    Proportion of eligible patients enrolled.

    Measured: baseline

  9. Retention: proportion of enrolled participants

    Proportion of enrolled participants providing data at 12 week post-test.

    Measured: baseline and 12 weeks

  10. Adverse events: number of adverse events

    Total number of adverse events (by cause if possible) evaluated by answers at post-test: The four questions addressing possible adverse events: 1) Have you carried out any type of treatment during the last 3 months? (With treatment we mean medication, physical exercise, self-management course or any alternative treatments) (yes/no), 2) If yes, have you experienced any adverse event as a result of the treatment? (yes/no). 3) If yes, which adverse events as a result of treatment? 4) In your opinion, which treatment(s) do you think the adverse event was/were caused by? (medication, physical exercise, self-management course, alternative treatments, other) (Elaborate).

    Measured: 12 weeks

Secondary outcomes (13)
  1. Changes in objectively measured physical activity

    Assessed by accelerometer (ActiGraph GT3X+): Change in physical activity level measured as counts per minute (CPM), which is the total number of registered counts for all valid days divided by wear time. Thresholds for CPM will be used in calculation of time (minutes per week/day) spent on sitting (<100 CPM), and on light (100-2019 CPM), moderate-(>2019-5998 CPM) and vigorous (>5998) intensity physical activity.

    Measured: baseline and 12 weeks

  2. Change in physical fitness (VO2 peak)

    Change in VO2 peak measured by indirect maximal cardiorespiratory exercise test (modified Balke-protocol). The indirect estimation of VO2 peak by prediction equations is based on incline, grade and speed at end stage, weight and age.

    Measured: baseline and 12 weeks

  3. Change in Hip disability and Osteoarthritis Outcome Score (HOOS)

    Change in the last week disability on five subscales; pain (10 items, scale 0-40), symptoms (5 items, scale 0-20), function in daily living (17 items, scale 0-68), function in sport and recreation (4 items, scale 0-16) and quality of life (4 items, scale 0-16). Items are scored by a five-point Likert scale ranging from 0 (least severe) to 4 (most severe). Total sum-score and subscale sum-scores will be converted to normalized scores ranging from 0 (extreme disability) to 100 (no disability).

    Measured: baseline and 12 weeks

  4. Change in Knee disability and Osteoarthritis Outcome Score (KOOS)

    Change in the last week disability on five subscales; pain (9 items, scale 0-36), symptoms (7 items, scale 0-28), function in daily living (17 items, scale 0-68), function in sport and recreation (5 items, scale 0-20) and quality of life (4 items, scale 0-16). Items are scored by a five-point Likert scale ranging from 0 (least severe) to 4 (most severe). Total sum-score and subscale sum-scores will be converted to normalized scores ranging from 0 (extreme disability) to 100 (no disability).

    Measured: baseline and 12 weeks

  5. Change in Patient-specific functional scale (PSFS)

    Patients will address one to three activities they have problems performing due to osteoarthritis. The degree of difficulty with performing these activities is rated from 0 (cannot perform the activity) to 10 (no problems).

    Measured: baseline and 12 weeks

  6. Change in self-reported physical activity (International Physical Activity Questionnaire-Short Form)

    Measured by The International Physical Activity Questionnaire-Short Form: Change in time (minutes per week/day) and Metabolic Equivalent of Task (MET-minutes per week/day) spent on sitting, walking, and moderate- and vigorous intensity physical activity the last week (0-7 days). METs are calculated by using the corresponding MET-values for walking (3.3 MET), and moderate-(4.0 MET) and vigorous (8.0 MET) intensity physical activity.

    Measured: baseline and 12 weeks

  7. Change in self-reported physical activity (HUNT)

    Measured by the three questions from the Nord-Trøndelag Health study (HUNT): change in average frequency (never/<1 per week/1 per week/2-3 per week/almost every day), intensity (easy without losing my breath or breaking into a sweat/so hard that I lose my breath and break into a sweat/I push myself to near-exhaustion) and duration (less than 15 minutes/15-29 minutes/30 minutes to 1 hour/more than 1 hour) of physical activity.

    Measured: baseline and 12 weeks

  8. Change in self-reported pain intensity the last week

    Measured by numeric rating scale ranging from 0 (no pain) to 10 (worst pain).

    Measured: baseline and 12 weeks

  9. Change in self-reported fatigue the last week

    Measured by numeric rating scale ranging from 0 (no fatigue) to 10 (worst fatigue).

    Measured: baseline and 12 weeks

  10. Change in self-reported disease activity the last week

    Measured by numeric rating scale ranging from 0 (good, no symptoms) to 10 (very bad, much symptoms).

    Measured: baseline and 12 weeks

  11. Change in Health-related quality of life (EQ-5D-5L)

    EQ-5D-5L will be used for measuring health-related quality of life (www.euroqol.org): comprises five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has five levels of answers (no problems, slight problems, moderate problems, severe problems, and extreme problems). The average score on each dimension will be reported, and the total score can be calculated into an index value ranging from -0.59 to 1, where -0.59 represents worst possible state and 1 represents perfect health.

    Measured: baseline and 12 weeks

  12. Change in Arthritis Self-Efficacy Scale (ASES)

    Measured by Arthritis Self-Efficacy Scale (ASES): comprises 11 items addressing pain and symptoms (scored on a 5-point scale ranging from not confident at all to very confident). The scores are summed up to a 0-100 score where higher score indicate better self-efficacy.

    Measured: baseline and 12 weeks

  13. Change in exercise self-efficacy

    Measured by Exercise Beliefs and Exercise Habits questionnaire: comprises 20 items addressing exercise self-efficacy (4 items), barriers to exercise (3 items), benefits of exercise (5 items), and impact of exercise on arthritis (8 items), scored on a 5-point Likert scale ranging from strongly disagree to strongly agree. The scores on each subscale is summed up where higher scores indicate better self-efficacy.

    Measured: baseline and 12 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Sep 2019
  2. Study start9 Oct 2019
  3. Primary completion1 Jun 2020
  4. Study completion1 Jun 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
A pre-post single arm feasibility study
Masking
None (open label)
Enrolment
31 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04084834
Sponsor's protocol ID
2018/2198-feasibility
Acronym
AktiWeb
Status last verified
Sep 2022
First submitted
21 Aug 2019
Last updated
22 Sep 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Data can possibly be made available on request

Publications

  • Joseph KL, Dagfinrud H, Hagen KB, Norden KR, Fongen C, Wold OM, Hinman RS, Nelligan RK, Bennell KL, Tveter AT. Adherence to a Web-based Exercise Programme: A Feasibility Study Among Patients with Hip or Knee Osteoarthritis. J Rehabil Med. 2023 Aug 14;55:jrm7139. doi: 10.2340/jrm.v55.7139.

    PubMed 37578100
  • Joseph KL, Dagfinrud H, Hagen KB, Norden KR, Fongen C, Wold OM, Hinman RS, Nelligan RK, Bennell KL, Tveter AT. The AktiWeb study: feasibility of a web-based exercise program delivered by a patient organisation to patients with hip and/or knee osteoarthritis. Pilot Feasibility Stud. 2022 Jul 20;8(1):150. doi: 10.1186/s40814-022-01110-3.

    PubMed 35859065

Questions about this trial

What is this clinical trial studying?

A study testing Exercise in people with Osteoarthritis, Knee and Osteoarthritis, Hip, run by Diakonhjemmet Hospital at 1 site in Norway.

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 1 inclusion and 6 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 22 Sep 2022. 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 Norway. 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?

Feasibility: time resources used by peer-supporters (time frame: baseline to 12 weeks). The study lists 10 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 NCT04084834, which also lists 2 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 22 Sep 2022.

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