A Community-Based Physical Activity Counselling Program for People With Knee Osteoarthritis: Feasibility and Preliminary Efficacy of the Track-OA Study
Open accessAbstract
BACKGROUND: Physical activity can improve health outcomes in people with knee osteoarthritis (OA); however, participation in physical activity is very low in this population. OBJECTIVE: The objective of our study was to assess the feasibility and preliminary efficacy of the use of wearables (Fitbit Flex) and telephone counselling by a physical therapist (PT) for improving physical activity in people with a physician-confirmed diagnosis of knee OA, or who have passed 2 validated criteria for early OA. METHODS: We conducted a community-based feasibility randomized controlled trial. The immediate group (n=17) received a brief education session by a physical therapist, a Fitbit Flex activity tracker, and a weekly telephone call for activity counselling with the physical therapist. The delayed group (n=17) received the same intervention 1 month later. All participants were assessed at baseline (T0), and the end of 1 month (T1) and 2 months (T2). Outcomes were (1) mean moderate to vigorous physical activity time, (2) mean time spent on sedentary behavior, (3) Knee Injury and Osteoarthritis Outcome Score (KOOS), and (4) Partners in Health Scale. Feasibility data were summarized with descriptive statistics. We used analysis of covariance to evaluate the effect of the group type on the outcome measures at T1 and T2, after adjusting for blocking and T0. We assessed planned contrasts of changes in outcome measures over measurement periods. RESULTS: We identified 46 eligible individuals; of those, 34 (74%) enrolled and no one dropped out. All but 1 participant adhered to the intervention protocol. We found a significant effect, with the immediate intervention group having improved in the moderate to vigorous physical activity time and in the Partners in Health Scale at T0 to T1 compared with the delayed intervention group. The planned contrast of the immediate intervention group at T0 to T1 versus the delayed group at T1 to T2 showed a significant effect in the sedentary time and the KOOS symptoms subscale, favoring the delayed group. CONCLUSIONS: This study demonstrated the feasibility of a behavioral intervention, supported by the use of a wearable device, to promote physical activity among people with knee OA. TRIAL REGISTRATION: ClinicalTrials.gov NCT02313506; https://clinicaltrials.gov/ct2/show/NCT02313506 (Archived by WebCite at http://www.webcitation.org/6r4P3Bub0).
AI snapshot
Written from the paper’s full text.
TL;DR
Track-OA was a community-based feasibility randomized controlled trial (N=34) testing Fitbit Flex plus physical therapist telephone counselling for people with knee osteoarthritis. It met retention and adherence targets but fell short on recruitment, with preliminary signals favoring the immediate group for MVPA and self-management at 1 month and unexpected delayed-group improvements in sedentary time and KOOS symptoms.
Key findings
- Feasibility: 46 eligible individuals were identified, 34 (74%) enrolled, 0% dropped out, 88% (30/34) adhered to the intervention and assessment protocol, and there was 0% SenseWear loss or malfunction; no adverse events were reported.
- At T0 to T1, the immediate group improved significantly compared with the delayed group in daily bouted MVPA ≥3 METs (contrast coefficient –31.1, 95% CI –56.6 to –5.7; P=.02) and Partners in Health Scale scores (contrast coefficient 10.9, 95% CI 2.5-19.3; P=.02).
- In the planned contrast comparing immediate group T0-T1 with delayed group T1-T2, significant effects favored the delayed group for sedentary time (contrast coefficient –83.6, 95% CI –154.1 to –13.1; P=.03) and KOOS symptoms subscale (contrast coefficient 6.9, 95% CI 0.4-13.5; P=.048).
- No significant effects were found in the contrast comparing immediate group T0-T1 with delayed group T0-T2; imputation analyses were consistent with the main missing-at-random analysis.
Methods
- Community-based feasibility randomized controlled trial using a delayed-control design: participants were randomized 1:1 to immediate intervention or a 1-month delayed intervention; all received the intervention by the end of the study.
- Participants were adults with physician-confirmed knee OA or who met 2 validated criteria for early OA; 34 enrolled (17 immediate, 17 delayed), mean age 55.5 (SD 8.6) years, 82% women, mean BMI 27.2 (SD 4.7) kg/m².
- Intervention: 1.5-hour group education session, Fitbit Flex wrist tracker, and 4 weekly 20-minute telephone counselling calls with a physical therapist using brief action planning; outcomes included SenseWear-measured bouted MVPA (primary), sedentary time, KOOS, and Partners in Health Scale, analyzed with ANCOVA adjusted for blocking and baseline plus planned contrasts.
Limitations
- The paper states it did not assess the full spectrum of feasibility, specifically demand (intent to use) and acceptability (intent to continue use and satisfaction); the sample was relatively active at baseline; and 82% of participants were women, limiting examination of sex effects.
- The paper states that analyses were not adjusted for multiple comparisons, so significant results cannot be ruled out as due to chance.
- Evident from the text: the sample was small (N=34) and recruitment was 74%, below the prespecified 80% target; baseline group differences in age and BMI (immediate group younger and higher BMI) may affect comparisons.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
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Cites
Statistics
Claims the paper makes
0 of 53 cited sources checked · 0 supported · 0 flagged
- Findingown data
Results from the imputation analysis were in line with the main missing-at-random analysis in estimates, standard errors, and P values of group effects.
“Results from the imputation analysis (data not shown) were in line with the main missing-at-random analysis, in estimates, standard errors, and P values of group effects.”
Quote in the paperNot a substantial claim - Findingnone given
There was a significant difference in the KOOS symptoms subscale between the immediate group at T0 to T1 and the delayed group at T1 to T2.
“Our result in the KOOS symptoms subscale was similar, with a significant difference found between the immediate group at T0 to T1 and the delayed group at T1 to T2.”
Quote in the paperNot a substantial claim- Rests on an assumption: Other KOOS subscales are also associated with symptom severity.
- Findingnone given
There was a lack of significant difference in other KOOS subscales.
“it should be viewed in the context of the lack of a significant difference in other KOOS subscales”
Quote in the paperSubstantial claim - Findingreasoning
The intervention appeared to have a more favorable effect in the delayed group (T1 to T2) than in the immediate group (T0 to T1) on sedentary behavior.
“the intervention appeared to have a more favorable effect in the delayed group (T1 to T2) than in the immediate group (T0 to T1)”
Quote in the paperNot a substantial claim - Findingown data
The immediate group showed a trend of improvement in the Partners in Health Scale compared with the delayed group at T0 to T1.
“with the immediate group showing a trend of improvement in MVPA (≥3 METs) and the Partners in Health Scale compared with the delayed group at T0 to T1”
Quote in the paperSubstantial claim
- Findingown data
The planned contrast of the immediate group at T0 to T1 versus the delayed group at T1 to T2 showed a significant effect in sedentary time (contrast coefficient -83.6, 95% CI -154.1 to -13.1; P=.03), favoring the delayed group.
“The planned contrast of the immediate group at T0 to T1 versus the delayed group at T1 to T2 showed a significant effect in sedentary time (contrast coefficient –83.6, 95% CI –154.1 to –13.1; P=.03)”
Quote in the paperNot a substantial claim- The authors state this as an assumption: Data were missing at random.
- Findingown data
The sample was relatively active.
“Second, our sample was relatively active as indicated by the high bouted MVPA (≥3 METs) minutes at baseline.”
Quote in the paperSubstantial claim - Findingown data
There was no significant effect in any outcome measures in the contrasts comparing the immediate group at T0 to T1 with the delayed group at T0 to T2.
“We found no significant effect in any outcome measures in the contrasts comparing the immediate group at T0 to T1 with delayed group at T0 to T2.”
Quote in the paperNot a substantial claim- The authors state this as an assumption: Data were missing at random.
- Findingown data
Changes in MVPA appeared to be similar in both groups after they received the intervention.
“Also, changes in MVPA appeared to be similar in both groups after they received the intervention.”
Quote in the paperNot a substantial claim - Findingown data
All 34 participants met SenseWear wear criteria at T0 and T1.
“All 34 participants met these wear criteria at T0 (mean number of days worn: 5.9, SD 0.3; mean off-body time: 23.1, SD 13.6 minutes) and T1 (mean number of days worn: 5.6, SD 0.7; mean off-body time: 24.8, SD 18.0 minutes).”
Quote in the paperNot a substantial claim - Findingown data
There was no noticeable effect at T0 to T1 between the 2 groups on sedentary behavior outcome measures.
“While there was no noticeable effect at T0 to T1 between the 2 groups on these outcome measures”
Quote in the paperSubstantial claim - Findingown data
Participant and equipment retention exceeded the target in a community-based study.
“we exceeded the target in participant and equipment retention in a community-based study”
Quote in the paperSubstantial claim - Findingown data
The immediate group showed a trend of improvement in MVPA (≥3 METs) compared with the delayed group at T0 to T1.
“with the immediate group showing a trend of improvement in MVPA (≥3 METs) and the Partners in Health Scale compared with the delayed group at T0 to T1”
Quote in the paperSubstantial claim - Findingown data
No adverse event associated with the intervention was reported by participants during the study.
“No adverse event associated with the intervention was reported by participants during the study.”
Quote in the paperNot a substantial claim - Findingown data
Baseline bouted MVPA (≥3 METs) minutes were high.
“as indicated by the high bouted MVPA (≥3 METs) minutes at baseline”
Quote in the paperSubstantial claim - Findingnone given
All participants completed the assessments as per protocol at T0 and T1.
“All participants completed the assessments as per protocol at T0 and T1.”
Quote in the paperSubstantial claim - Findingown data
The immediate group improved in moderate to vigorous physical activity (≥3 METs) time at T0 to T1 compared with the delayed group (contrast coefficient -31.1, 95% CI -56.6 to -5.7; P=.02).
“Prespecified contrast analyses revealed a significant effect whereby the immediate group improved in the MVPA (≥3 METs) time at T0 to T1 compared with the delayed group (contrast coefficient –31.1, 95% CI –56.6 to –5.7; P=.02) (Table 3).”
Quote in the paperSubstantial claim- The authors state this as an assumption: Data were missing at random.
- Findingown data
There was a significant effect in Partners in Health Scale scores at T0 to T1 (contrast coefficient 10.9, 95% CI 2.5-19.3; P=.02).
“We also found a significant effect in the Partners in Health Scale scores at T0 to T1 (contrast coefficient 10.9, 95% CI 2.5-19.3; P=.02).”
Quote in the paperSubstantial claim- The authors state this as an assumption: Data were missing at random.
- Findingown data
All but 1 participant adhered to the intervention protocol.
“All but 1 participant adhered to the intervention protocol.”
- Also stated in: § Feasibility · plain
“All but 1 participant adhered to the intervention protocol.”
Quote in the paperNot a substantial claim - Also stated in: § Feasibility · plain
- Findingown data
At T2, 31 participants adhered to the SenseWear wear criteria.
“At T2, 31 participants adhered to the wear criteria (mean number of days worn: 5.7, SD 0.6; mean off-body time: 38.4, SD 27.9 minutes).”
Quote in the paperNot a substantial claim - Findingown data
The recruitment rate was below the goal of 80%.
“While our strategy yielded a recruitment rate below the goal of 80%”
Quote in the paperNot a substantial claim - Findingown data
The planned contrast of the immediate group at T0 to T1 versus the delayed group at T1 to T2 showed a significant effect in the KOOS symptoms subscale (contrast coefficient 6.9, 95% CI 0.4-13.5; P=.048), favoring the delayed group.
“and the KOOS symptoms subscale (contrast coefficient 6.9, 95% CI 0.4-13.5; P=.048), favoring the delayed group at T1 to T2.”
Quote in the paperNot a substantial claim- The authors state this as an assumption: Data were missing at random.
- Findingown data
82% of participants were women.
“Finally, 82% of participants were women.”
Quote in the paperSubstantial claim - Findingown data
88% of participants adhered to the study protocol.
“with 88% of participants adhering to the study protocol”
Quote in the paperSubstantial claim - Premisecitation
Over 90% of people with knee osteoarthritis did not meet the physical activity guidelines of 150 minutes of moderate to vigorous physical activity per week.
“A 2011 study using accelerometers found that over 90% of people with knee OA did not meet the physical activity guidelines of 150 minutes of moderate to vigorous physical activity (MVPA) per week [8].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [8] source
Not checked in the free run.
- Interpretationreasoning
By ensuring that all participants receive the intervention at the end of a study, the delayed-control design might promote protocol compliance.
“By ensuring that all participants receive the intervention at the end of a study, this design might promote protocol compliance.”
Quote in the paperSubstantial claim- Rests on an assumption: The intervention components are likely beneficial and present a low risk to participants.
- Premisecitation
Only 13% of people with osteoarthritis met physical activity guidelines.
“These findings concur with a 2013 systematic review that found that only 13% of people with OA met physical activity guidelines [10].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [10] source
Not checked in the free run.
- Premisecitation
The detrimental health effect of sitting too much is independent of the person's activity level.
“The detrimental health effect of sitting too much is independent of the person’s activity level.”
Quote in the paperSubstantial claim0 of 5 sources checked - Premisecitation
A 2007 meta-analysis of 8 randomized controlled trials reported a significant difference in improvement of physical activity among pedometer users compared with controls (mean difference 2491 steps/day, 95% CI 1098-3885).
“A 2007 meta-analysis of 8 randomized controlled trials (RCTs) reported a significant difference in the improvement of physical activity among pedometer users compared with controls (mean difference 2491 steps/day, 95% CI 1098-3885) [23].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [23] source
Not checked in the free run.
- Premisecitation
People with osteoarthritis may have difficulties with moderate to vigorous physical activity due to pain.
“people with OA may have difficulties with MVPA due to pain [11-13].”
Quote in the paperSubstantial claim0 of 3 sources checked - Premisecitation
Fewer than half of people with knee or hip osteoarthritis in Canada walked one or more hours per week for exercise, even among people with mild symptoms.
“A survey of 1713 people with knee or hip OA in Canada reported that fewer than half walked “one or more hours per week for exercise,” even among people with mild symptoms [9].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [9] Li, L, 2008, British Columbia Osteoarthritis Survey
Not checked in the free run.
- Premisecitation
In a community-based study by Marra et al, 191 of 195 (98.0%) urban-dwelling participants who met the early osteoarthritis criteria also met the American College of Rheumatology clinical criteria for knee osteoarthritis.
“In a community-based study by Marra et al [27], 191 of 195 (98.0%) urban-dwelling participants who met these criteria also met the American College of Rheumatology clinical criteria for knee OA [28].”
Quote in the paperSubstantial claim0 of 2 sources checked - Premisecitation
Light activities, even below moderate intensity, can provide health benefits.
“Interestingly, light activities, even done below the moderate-intensity level (eg, daily tasks done while standing or walking slowly), can provide health benefits [19-21].”
Quote in the paperSubstantial claim0 of 3 sources checked - Premisecitation
Participation in physical activity is very low in people with knee osteoarthritis.
“however, participation in physical activity is very low in this population.”
- Also stated in: § Introduction · plain
“however, participation in physical activity is very low in this population.”
Quote in the paperSubstantial claim0 of 3 sources checked - Also stated in: § Introduction · plain
- Premisecitation
A sedentary lifestyle is a predictor of poor health outcomes.
“Studies have indicated that a sedentary lifestyle (ie, too much sitting) is a predictor of poor health outcomes [14-18].”
Quote in the paperSubstantial claim0 of 5 sources checked - Premisecitation
Wearable devices may be beneficial in clinical populations.
“Evidence suggests they may also be beneficial in clinical populations.”
Quote in the paperSubstantial claim0 of 2 sources checked - Study design and conductnone given
The study did not assess the full spectrum of feasibility.
“First, we did not assess the full spectrum of feasibility.”
Quote in the paperNot a substantial claim - Study design and conductreasoning
We cannot rule out the possibility that the results were due to chance.
“hence, we cannot rule out the possibly that the results were due to chance”
Quote in the paperSubstantial claim - Interpretationown data
It is feasible to use an objective physical activity measure (SenseWear) for data collection in the community.
“We have also demonstrated that it is feasible to use an objective physical activity measure (ie, SenseWear) for data collection in the community.”
Quote in the paperSubstantial claim - Premisecitation
SenseWear is a valid tool for estimating energy expenditure during daily activities in people with arthritis (intraclass correlation coefficient 0.72).
“Tierney et al [37] showed that SenseWear is a valid tool for estimating energy expenditure during daily activities in people with arthritis (intraclass correlation coefficient 0.72).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [37] source
Not checked in the free run.
- Interpretationcitation
Compared with Fitbit, SenseWear is a superior outcome measure because of its ability to differentiate between sedentary and light activities.
“Compared with Fitbit, SenseWear is a superior outcome measure because of its ability to differentiate between sedentary and light activities [36].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [36] source
Not checked in the free run.
- Interpretationown data
The study demonstrated the feasibility of a behavioral intervention, supported by the use of a wearable device, to promote physical activity.
“This study demonstrated the feasibility of a behavioral intervention, supported by the use of a wearable device, to promote physical activity.”
Quote in the paperSubstantial claim - Premisecitation
Programs targeting physical activity or combined activity and sedentary behavior are effective at improving physical activity participation.
“although programs targeting physical activity or combined activity and sedentary behavior are effective at improving physical activity participation”
Quote in the paperSubstantial claim0 of 3 sources checked - Interpretationown data
The intervention and study protocol can be delivered within the resource constraints.
“we have shown that the intervention and study protocol can be delivered within the resource constraints”
Quote in the paperSubstantial claim - Study design and conductcitation
The study did not address demand (intent to use) and acceptability (intent to continue use and satisfaction) by people with arthritis.
“we did not address demand (ie, intent to use) and acceptability (ie, intent to continue use and satisfaction) by people with arthritis [31].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [31] source
Not checked in the free run.
- Interpretationown data
The presence of missing data did not have an important effect on the findings.
“This suggests that the presence of missing data did not have an important effect on the findings.”
Quote in the paperSubstantial claim - Interpretationown data
The physical activity counselling program demonstrated preliminary efficacy.
“Our results have also demonstrated preliminary efficacy of the physical activity counselling program”
Quote in the paperSubstantial claim - Premisecitation
Only programs designed to change sedentary behavior achieve the best results in reducing sitting time.
“only the ones that are designed to change sedentary behavior achieve the best results in reducing sitting time”
Quote in the paperSubstantial claim0 of 3 sources checked - Interpretationown data
This study demonstrated the feasibility of a behavioral intervention, supported by the use of a wearable device, to promote physical activity among people with knee osteoarthritis.
“This study demonstrated the feasibility of a behavioral intervention, supported by the use of a wearable device, to promote physical activity among people with knee OA.”
Quote in the paperSubstantial claim - Study design and conductnone given
The analysis was not adjusted for multiple comparisons.
“It should be noted that we did not adjust the analysis for multiple comparisons”
Quote in the paperSubstantial claim - Premisecitation
The eligibility criteria were in line with other physical activity intervention studies involving people with knee OA.
“Since our eligibility criteria were in line with other physical activity intervention studies involving people with knee OA [4]”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [4] source
Not checked in the free run.
- Interpretationnone given
The results contributed to refining the counselling protocol, the recruitment strategy, and the timeline for a series of studies.
“The results have contributed to refining the counselling protocol, the recruitment strategy, and the timeline for a series of studies to evaluate the efficacy of this program.”
Quote in the paperSubstantial claim- Rests on an assumption: Patients who are inactive are more likely to need active intervention.
- Rests on an assumption: Men and women may respond to behavioral interventions differently.
- May combine two claims. 13
- Classified as probably not a substantial claim. 11
May combine two claims.
Findingown dataBetween January and March 2015 (7 weeks), 149 people expressed interest to participate, and 46 met eligibility criteria; 34 were enrolled and completed the study.
“Between January and March, 2015 (7 weeks), 149 people expressed an interest to participate, and 46 met the eligibility criteria. Of those, 34 were enrolled and completed the study (Figure 1).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe recruitment strategy identified 46 eligible individuals; of those, 34 (74%) enrolled and none dropped out.
“We identified 46 eligible individuals; of those, 34 (74%) enrolled and no one dropped out.”
- Also stated in: § Feasibility · plain
“Our recruitment strategy identified 46 eligible individuals; of those, 34 (74%) enrolled and none dropped out (Table 2).”
Quote in the paperSubstantial claim- Also stated in: § Feasibility · plain
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataIn the delayed group, 1 participant did not complete the outcome measures.
“In the delayed group, 1 participant did not complete the outcome measures.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationLewis et al found preliminary evidence of improvement in physical activity participation and body weight with wearables, but no difference when compared with other behavioral change interventions; only 1 included study was high quality.
“In a systematic review of 11 studies evaluating wearables (1272 participants), Lewis et al [25] found preliminary evidence of improvement in physical activity participation and body weight, but no difference when compared with other behavioral change interventions. Only 1 of the included studies was deemed to be of high quality.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [25] source
Not checked in the free run.
May combine two claims.
PremisecitationTalbot et al found an average increase of 23% in daily steps and 21% in isometric quadriceps muscle strength in people with knee osteoarthritis who received a pedometer-driven walking program plus self-management education compared with an education-only group.
“For example, Talbot et al [22] combined a pedometer-driven walking program with self-management education for people with knee OA and found an average increase of 23% in individuals’ daily steps and of 21% in isometric quadriceps muscle strength, compared with an education only group [22].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [22] Talbot, L, 2003, J Am Geriatr Soc source
Not checked in the free run.
May combine two claims.
Study design and conductreasoningThe randomized delayed-control design allows preliminary efficacy to be assessed within a conventional randomized controlled trial at 1 month while all participants receive the intervention after 1 month.
“As such, preliminary efficacy could be assessed within a conventional RCT (ie, with an intervention group and a control group) at 1 month, while all participants received the intervention after 1 month.”
Quote in the paperSubstantial claim- Rests on an assumption: The intervention components are likely beneficial and present a low risk to participants.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe research protocol was approved by the University of British Columbia Clinical Research Ethics Board (application number: H14-02631).
“The research protocol was approved by the University of British Columbia Clinical Research Ethics Board (application number: H14-02631)”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Premisecitation57% of people with arthritis were physically inactive during leisure time, compared with 46% of those without arthritis.
“The 2011 Canadian Community Health Survey also found that 57% of people with arthritis were physically inactive during their leisure time, compared with 46% of those without arthritis (Multimedia Appendix 1).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Multimedia Appendix 1
Not checked in the free run.
Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.
InterpretationreasoningThere is a need for interventions to both improve time spent in moderate to vigorous physical activity and decrease sitting time.
“Hence, there is a need for interventions to both improve the time spent in MVPA and decrease sitting time.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationConsumer wearables usually include motivational techniques such as self-monitoring and real-time feedback, but rarely address skills such as action planning and problem solving, which are essential to changing physical activity behavior.
“In a review of 13 consumer wearables, Lyons et al [24] concludes that these devices usually include motivational techniques, such as self-monitoring and real-time feedback, but rarely address skills such as action planning and problem solving, which are essential to changing physical activity behavior.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [24] source
Not checked in the free run.
May combine two claims.
PremisecitationPhysical activity can improve pain, mobility, and quality of life in people with knee osteoarthritis.
“It is well known that physical activity can improve pain, mobility, and quality of life in people with knee osteoarthritis (OA) [1-4].”
Quote in the paperSubstantial claim0 of 4 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe immediate group was younger than the delayed group (mean age 52.3, SD 9.7 vs 58.7, SD 6.0 years).
“with the immediate group (mean age 52.3, SD 9.7 years; n=17) younger than the delayed group (mean 58.7, SD 6.0 years; n=17).”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationSenseWear is a research-based accelerometer and sensor with established measurement properties.
“SenseWear is a research-based accelerometer and sensor with established measurement properties [36].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [36] source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown dataThe mean body mass index was 27.2 (SD 4.7) kg/m2, with the immediate group higher than the delayed group (29.1 vs 25.4).
“The mean body mass index was 27.2 (SD 4.7) kg/m2, with the immediate group (mean 29.1, SD 4.5) higher than the delayed group (mean 25.4, SD 4.2) (Table 1).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThe Partners in Health Scale is a 12-item measure designed to assess perceived self-management capacity via subjective knowledge of the health condition and treatment, and perceived self-management behavior (Cronbach alpha=.82).
“The Partners in Health Scale is a 12-item measure designed to assess perceived self-management capacity via subjective knowledge of the health condition and treatment, and perceived self-management behavior (eg, adopting a healthy lifestyle) (Cronbach alpha=.82) [41].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [41] source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationSeveral recent systematic reviews have raised similar issues.
“Similar issues have been raised by several recent systematic reviews on interventions to change activity behavior [47-49].”
Quote in the paperNot a substantial claim0 of 3 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationPrevious studies on physical activity interventions generally result in short-term improvement (within 6 months).
“These findings are in line with previous studies on physical activity interventions, which generally result in short-term improvement (within 6 months) [4].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [4] source
Not checked in the free run.
May combine two claims.
InterpretationreasoningThe Track-OA study developed a physical activity counselling program that is practical and can be implemented in a full RCT.
“in the Track-OA study we have developed a physical activity counselling program that is practical and can be implemented in a full RCT”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe trial was registered with ClinicalTrials.gov (NCT02313506).
“was registered with ClinicalTials.gov (NCT02313506)”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe Knee Injury and Osteoarthritis Outcome Score has been validated in people with osteoarthritis.
“It was originally developed for people recovering from anterior cruciate ligament and meniscus injury and has been validated in people with OA [39,40].”
Quote in the paperNot a substantial claim0 of 2 sources checked
The authors state this as an assumption.
Data were missing at random.
“which assumed that data were missing at random.”
The paper relies on this without support.
Wearable devices such as fitness bands and smart watches offer additional features compared with pedometers, such as tracking intensity and visualizing activity performance over time.
“Compared with pedometers, wearable devices such as fitness bands and smart watches offer additional features, such as the ability to track the intensity of activities and to visualize activity performance over time.”
The paper relies on this without support.
The intervention components are likely beneficial and present a low risk to participants.
“This study design is the best suited for complex interventions with components that are likely beneficial and present a low risk to participants (eg, promoting physical activity).”
The paper relies on this without support.
Patients who are inactive are more likely to need active intervention.
“Since patients who are inactive are more likely to need active intervention”
The paper relies on this without support.
Men and women may respond to behavioral interventions differently.
“Since men and women may respond to behavioral interventions differently”
The paper relies on this without support.
Other KOOS subscales are also associated with symptom severity.
“which are also associated with symptom severity”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Less time was spent in sedentary behavior for those receiving a consumer-based wearable activity tracker intervention compared with control groups; however, the finding was not significant, and the quality of the evidence was graded as very low.
“Less time was spent in sedentary behavior for those receiving a consumer-based wearable activity tracker intervention compared with control groups; however, the finding was not significant, and the quality of the evidence was graded as very low [29,31-33,37-40].”
From Consumer-based wearable activity trackers increase physical activity participation: systematic review and meta-analysis (2019) · cites this paper as [39]
Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measured17 studies specified that participants must have regular access to the internet, a computer, tablet, and/or smartphone.
“Furthermore, 17 studies specified that the participant must have regular access to the internet, a computer, tablet, and/or smartphone [21,30,33,35-37,39,41-47,51-53]”
From Consumer-based wearable activity trackers increase physical activity participation: systematic review and meta-analysis (2019) · cites this paper as [39]
The significant heterogeneity in MVPA is most likely because of the inclusion of a greater range of intervention types and the method by which MVPA was measured, including two studies that subjectively measured MVPA and another study that presented MVPA data in bouts.
“This is most likely because of the inclusion of a greater range of intervention types when compared with other outcome measures and the method by which MVPA was measured, including 2 studies [30,48] that subjectively measured MVPA and another study [39] that presented MVPA data in bouts.”
From Consumer-based wearable activity trackers increase physical activity participation: systematic review and meta-analysis (2019) · cites this paper as [39]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Incorrect percentage for immediate-group participants reporting good health
MinorThe table reports 4 immediate-group participants with good health as 26%, but 4 of 17 is 23.5%, or 24% rounded to a whole percent.
Reported 26 · recomputed 23.529412
“| | Good | 13 (38) | 4 (26) | 9 (53) | |”
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- Authors
- Li, L. C., Sayre, E. C., Xie, H., Clayton, C., & Feehan, L. M.
- Affiliations
- University of British Columbia (CA)
- Simon Fraser University (CA)
- Corresponding author
- Li, Linda C
- Venue
- JMIR mHealth and uHealth
- Publisher
- JMIR Publications Inc.
- Published
- 2017-06-26
- Volume
- 5
- Issue
- 6
- Pages
- e86
- ISSN
- 2291-5222 (ISSN-L)
- PMC
- PMC5504340
- OpenAlex
- W2697803655
- Semantic Scholar
- fd8c2ecc8f89d9423a79ee8b5c8c9430fc05411c
- Cited by
- 74
- References
- 49
- Citations by year
- 2026: 5 · 2025: 2 · 2024: 7 · 2023: 8 · 2022: 11 · 2021: 9 · 2020: 7 · 2019: 9 · 2018: 15 · 2017: 1
- FWCI
- 6.48
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR mhealth and uhealth (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- knee osteoarthritis, physical activity counseling, wearable activity trackers, Fitbit, telephone counseling, physiotherapists, sedentary behavior, moderate-to-vigorous physical activity, behavioral interventions, early osteoarthritis, KOOS, Partners in Health Scale, community-based intervention, feasibility, intervention timing, social support
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