Osteoarthritis Clinical Trial
The objectives of this research are to conduct a proof of concept randomized controlled trial with 200 patients undergoing primary total knee replacement (TKR) at Brigham and Women's Hospital (BWH). The trial will compare levels of physical activity in subjects in the behavioral and economic interventions versus "Usual Care" post TKR.
Physical activity (PA) has been shown to improve pain and function in persons with knee
osteoarthritis (OA), reduce obesity, and prevent the onset and progression of heart disease,
diabetes, and chronic pulmonary disease. The US Department of Human and Health Services
(DHHS) guidelines recommend that adults engage in >150 minutes of moderate physical activity
per week. However, adherence to PA guidelines is poor in the general population, particularly
in persons with knee OA.
Total knee replacement (TKR) is widely used in patients with symptomatic, advanced knee OA.
While the vast majority of persons undergoing TKR experience considerable reduction in pain
and improvement in functional capacity, far fewer take this opportunity to become more
physically active. Since physical activity has a direct relationship with quality of life and
with prevention and amelioration of many chronic conditions, many TKR recipients do not
derive maximum benefits from the procedure.
The focus of this proposal is to conduct a proof of concept RCT to establish the efficacy of
a behavioral economics-based intervention that would facilitate engagement in physical
activity and improve adherence to PA guidelines in the growing population of TKR recipients.
We address the innovative hypothesis that the period following TKR presents a window of
opportunity to fundamentally change attitudes and beliefs regarding PA, and that tangible
economic incentives will effectively induce behavior change and facilitate adherence to PA
guidelines.
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