Adapting Rehabilitation Delivery for Maximum Impact at Home-2 (ReDI-2)

Condition(s) studied

Investigational drug(s) / intervention(s)

Individual-based Virtual Physical Therapy Program: Twelve-week virtual physical therapy that includes one-on-one visits with a physiotherapist. Multi-modal Self-management program comprises: * Education to understand OA and its management: 'Understanding \& Managing OA'; 'Activity \& Exercise'; 'Managing Pain'; 'Healthy Eating'; 'Mental \& Emotional Well-being'; 'General Wellness'. * Personalized Goal Setting in partnership with therapist to promote patient activation. * Progressive neuro-muscular exercises of the core and lower extremity, customized to patient capacity with participants encouraged to perform exercises at least 2 times/week between PT sessions to improve strength and function; 2 levels of resistance bands will be provided to progress resistance. * Physical activity goals using FitBit step count, to increase daily activity as tolerated.

Group-based Virtual Physical Therapy Program: Twelve-week virtual physical therapy that includes group classes (4-5 participants) with two physiotherapists. In each session, each participant will also have a 10-12 min one-on-one interaction with one of the physiotherapists. Multi-modal Self-management program comprises: Education to understand OA and its management: 'Understanding \& Managing OA'; 'Activity \& Exercise'; 'Managing Pain'; 'Healthy Eating'; 'Mental \& Emotional Well-being'; 'General Wellness'. Personalized Goal Setting in partnership with therapist to promote patient activation. Progressive neuro-muscular exercises of the core and lower extremity, customized to patient capacity with participants encouraged to perform exercises at least 2 times/week between PT sessions to improve strength and function; 2 levels of resistance bands will be provided to progress resistance. Physical activity goals using FitBit step count, to increase daily activity as tolerated.

Study summary

People who live in rural areas and have hip or knee arthritis can have difficulty receiving physical therapy (PT) close to home. Living with hip or knee arthritis can make doing daily activities and being physically active difficult. This can lead to other health conditions, such as becoming overweight, or lessen enjoyment of life.

We will compare 2 programs that allow physical therapists to treat rural residents in their own home to each other and to usual care. Usual care is the care that is typically provided to people living with hip or knee arthritis.

For the first 12 weeks, participants will continue usual osteoarthritis (OA) care and then complete the standardized questionnaires again. Then, they will be randomized to either Individual (IPT) or Group-based PT (GPT).

Over 12-weeks, therapists will meet virtually with patients using Zoom so that patients and therapists can see each other. The program will be either a class or one-on-one with a therapist. In the class, participants will still receive private one-to-one time with the therapist using a Zoom 'breakout' room. Therapists in both groups will help patients do exercises correctly in their home. Patients can also see and talk to the therapists to discuss their challenges in living with OA and set personalized goals including pain management, participating in valued daily activities, keeping healthy (diet, sleep) and being active. Both programs will allow patients who sometimes cannot access physical therapy to receive care in their home.

Eligibility

Primary outcome measure(s)

• Patient Activation Measure (PAM) — pre-usual care, pre-intervention, immediate post-intervention, 6-months post-intervention,12-months post-intervention
  Self-management will be measured using the validated 13-item Patient Activation Measure (PAM). Responses are scored to a total score on a 0-100-point scale with higher scores representing higher patient activation.

Trial sites (1)

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