Shah Nirali, Morone Natalia, Kim Ehyun, Ellis Terry D, Cohn Ellen, LaValley Michael P, Kumar Deepak
Department of Physical Therapy, Boston University, Boston, MA, USA.
Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
Osteoarthr Cartil Open. 2024 Jun 19;6(3):100494. doi: 10.1016/j.ocarto.2024.100494. eCollection 2024 Sep.
Negative psychological beliefs like fear avoidance and catastrophizing can interfere with exercise engagement in people with knee osteoarthritis (OA). Mindfulness, when integrated with exercise, could potentially address both psychological and physical impairments. Our objectives were to optimize and assess the feasibility of a novel telehealth, group-based mindful exercise intervention for people with knee OA.
We conducted a decentralized randomized controlled trial where participants (n = 40) with symptomatic knee OA were randomized into mindful exercise (n = 21) or exercise-only (n = 19) groups. Both groups received supervised group-based interventions weekly for 8-weeks via Zoom. Primary outcomes were safety, fidelity, and feasibility of the mindful exercise intervention. Participants completed patient-reported outcomes (PRO) for pain, function, and psychological measures at baseline, week-8, and week-14.
Participants were from 21 US states; >90% identified as having White race, 16% were from rural areas, and approximately 40% had an annual income < $50,000. At 8-weeks, mindful exercise and exercise groups had retention rates of 86% (18/21) and 100% (19/19), and attendance was 54% (11.4/21) and 68% (13/19) respectively. There were no adverse events in the mindful exercise group and four in the exercise group related to exacerbation of knee pain. Preliminary findings showed numerically larger improvements in several PROs for the mindful exercise group.
An 8-week telehealth, group-based, mindful exercise intervention was safe for people with knee OA. Our decentralized approach was feasible in terms of recruitment and retention. Further refinement is needed to improve intervention attendance and participant diversity.
恐惧回避和灾难化等消极心理信念会干扰膝骨关节炎（OA）患者的运动参与。正念与运动相结合，可能会解决心理和身体障碍问题。我们的目标是优化并评估一种针对膝OA患者的新型远程医疗、基于小组的正念运动干预措施的可行性。
我们进行了一项去中心化随机对照试验，将40名有症状的膝OA患者随机分为正念运动组（n = 21）和单纯运动组（n = 19）。两组均通过Zoom每周接受8周的基于小组的监督干预。主要结果是正念运动干预的安全性、保真度和可行性。参与者在基线、第8周和第14周完成了关于疼痛、功能和心理指标的患者报告结局（PRO）。
参与者来自美国21个州；超过90%的人认定为白人，16%来自农村地区，约40%的人年收入低于5万美元。在第8周时，正念运动组和运动组的保留率分别为86%（18/21）和100%（19/19），出勤率分别为54%（11.4/21）和68%（13/19）。正念运动组无不良事件，运动组有4例与膝关节疼痛加重有关。初步结果显示，正念运动组在几个PRO指标上的改善在数值上更大。
为期8周的远程医疗、基于小组的正念运动干预对膝OA患者是安全的。我们的去中心化方法在招募和保留方面是可行的。需要进一步改进以提高干预出勤率和参与者的多样性。
