Knee Osteoarthritis Clinical Trial
Official title:
Optimizing Mobility in Older Adults With Knee Osteoarthritis
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.
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.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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