Weill Medical College of Cornell University
The goal of this clinical trial is to learn if a behavioral program called I'M Walking will help with pain in middle-aged and older adults. * Does the program improve pain interference in participants with knee osteoarthritis? * What other factors may affect pain interference with participants that did the intervention? Researchers will compare the I'M Walking program with a Walk With Ease program (self-directed program)
Randomized controlled trial evaluating the I'M Walking program vs the Walk With Ease (WWE) program for older adults with symptomatic knee osteoarthritis. All participants will receive treatment for 3 months and complete a 3-month follow-up period. Data collection will occur at baseline, post-treatment (month 3), and at the end of the follow-up period (month 6).
Inclusion Criteria: * Age ≥50 years * Community-dwelling * ICD-10 codes for knee Osteoarthritis in electronic health record * Moderate to severe chronic pain using Graded Chronic Pain Scale-Revised (PEG score ≥4) * Knee pain-related difficulty with walking or climbing stairs * Owns a smart phone Exclusion Criteria: * Dementia (ICD-10 codes in EHR or T-MoCA score\<13) * Unable to independently walk a quarter mile
Participants in the I'M Walking arm will gain access to a website with 8 modules of a mindfulness-based intervention (MBI) which will include videos and a written manual with worksheets for practice and additional resources. Modules include information regarding integrating mindfulness into walking exercises, meditation practices, and mind-body awareness. The MBI is intended to reduce pain interference and encourage increased physical activity. The study team anticipates that each module will take approximately 45 minutes to complete, for a total of 360 minutes. A physical therapist will monitor patients' steps on the ExerciseRx app dashboard and will coach patients through completion of the 8 MBI modules. Through 4, 45-minute phone calls or videoconferences, the physical therapist will address patient concerns to implementing the MBI skills into their daily life and counsel them to increase physical activity through walking.
Participants in the Walk With Ease arm will be directed to use the publicly available WWE self-directed online program. Study staff will assist participants in making an account on the Osteoarthritis Action Alliance website where they can access the WWE book, videos, and interactive activity tracking modules. They will be instructed to complete 1 chapter per week. The WWE program is widely disseminated and available for older adults with osteoarthritis. A trained health educator will meet with each patient for 4, 30-45-minute phone calls and/or videoconferences to discuss the WWE program, answer questions, and provide arthritis education regarding pain management, exercise, and sleep.
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