Optimizing Physical Activity Outcomes After Total Knee Arthroplasty

Optimizing Physical Activity Outcomes for Veterans After Total Knee Arthroplasty

Although total knee arthroplasty is an effective intervention for decreasing knee pain and improving physical function, physical activity levels remain low up to a year after surgery. This study will use mobile-health technology to deliver an intervention designed to improve physical activity behavior for Veterans recovering from total knee arthroplasty. The study will assess the effectiveness of using behavior-change intervention as a supplement to conventional rehabilitation to improve physical activity. The intervention will be delivered using home-based tablet computers for Veterans to have remote interaction with the researcher and real-time physical activity feedback from a wrist-worn activity sensor.

This randomized clinical trial will assess the efficacy of using physical activity behavior change intervention for Veterans recovering from total knee arthroplasty. Testing will occur at baseline (before surgery), at intervention midpoint (8 weeks after surgery), end of intervention (14 weeks after surgery), and 24 weeks after intervention. The primary outcome is accelerometer-assessed daily step count. Secondary outcomes include the percent time engaged in standing and walking activity and physical function (Six-Minute Walk, 30-Second Chair-Stand Test, Timed Up-and-Go, Western Ontario and McMaster Universities Osteoarthritis Index, and the Veterans RAND 12-Item Health Survey.

Inclusion Criteria:

• Veteran
• Planned unilateral total knee arthroplasty

Exclusion Criteria:

• Severe non-surgical limb pain (pain >5/10 on non-surgical limb with walking)
• Unstable orthopedic, neurologic, or pulmonary condition that limits function
• Unstable cardiac condition
• Uncontrolled hypertension
• Uncontrolled diabetes
• Acute systemic infection
• Active cancer treatment
• Recent stroke (within 2 years)