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Dr. Kristin Baker, PhD, PI of ENACT’s BOOST study, and doctoral fellow Aileen Ledingham, PT, MS, recently spent time exercising with members of The Historic Peoples Baptist Church of Boston. The congregation at Peoples Baptist Church has achieved great success with its Health Ministry since it began several years ago. After starting a walking group with the support of ENACT and the New England Chapter of the Arthritis Foundation in 2010, the group has continued to ‘walk’ in strides! While the program has had excellent sustainability, the Boston winters always sidetrack the activity of the group. Those snow drifts can be pesky for people with arthritis!
To address this challenge, Dr. Baker extended our community programming initiatives by bringing the evidence-based BOOST exercise program to the members of the church to help them acquire a self-sustaining option to stay active during bad weather. Dr. Baker led one session per week for 4 weeks and then used some mHealth technology to support the interim sessions to encourage participants to develop confidence in both doing and leading the exercises. The group continues to use their BOOST training along with regular walking activity and anticipates that it will take them through the winter!
Peoples Baptist Church was recently a featured “FitChurch” in a Boston Black Ministerial Alliance video, where their accomplishments were touted as a model for other churches, with a goal of being replicated nationally in the religious community. Congratulations to Peoples on this well-earned recognition!
Click here to view all stories from our Year End 2016 Newsletter
Keep a look out for upcoming webinars where we’ll disseminate findings from our 2-year randomized controlled trials: 1) Efficacy of a Modified Vocational Rehabilitation Intervention for Work Disability (the “Work it Study”), and 2) Can computer-based telephone counseling improve long-term adherence to strength training in elders with knee OA? (the BOOST study).
In the Work It Study, we evaluated whether a job barrier identification and solution generation process delivered by trained occupational and physical therapists minimized work disability among people with rheumatic and musculoskeletal conditions who were at risk of work loss over the upcoming few years. This study addresses an extremely important outcome for people with chronic rheumatological and musculoskeletal conditions, with estimates showing approximately 33% of people with these conditions are unemployed within 10 years of diagnosis.
The BOOST study investigated if a remote interactive technology intervention could improve adherence to a strength training program over 2 years in people with knee OA more than an automated message to encourage adherence. The efficacy of strength training to impact pain and function for people with knee OA is well-established, but less than 15% of individuals over age 65 report doing any strength training and poor long-term adherence has been observed in other trials. An effective approach to encourage adherence to strength training activity could be helpful for this population.
Once the manuscripts are accepted and in press, we will host webinars to share our results. Stay tuned! We think we have important findings for the field and welcome discussion with our colleagues.
Click here to view all stories from our Year End 2016 Newsletter
If you’ll be in San Antonio in February for APTA-CSM, Julie Keysor, PhD, PT, will be there presenting results from the “Work It Study” trial. Physical therapists delivered a novel intervention addressing work-related barriers and solutions among adults with chronic rheumatological and musculoskeletal conditions who were at risk of work loss due to their health. This study could lead the way for therapists to intervene to prevent work disability for a population that is at high risk of work loss.
ENACT pre-doctoral fellow Aileen Ledingham, PT, MS will also be presenting her poster “Adults with Knee Osteoarthritis: Perspectives on Telephone Technology to Support Adherence to Exercise”, an ancillary qualitative study to ENACT’s BOOST trial. With her study, Ms. Ledingham explores the BOOST participant’s thoughts and perspectives on the technology used in the BOOST adherence study. Ms. Ledingham’s work may lead to novel ways to promote adherence to physical therapy programs.
ENACT investigators also brought the results of both randomized controlled trials to the arthritis research community at the November 2016 ACR/ARHP Annual Meeting in Washington, DC.
Dr. Keysor presented the main results from the “Work-it” employment outcomes study during a joint ACR/ARHP on November 15th and Kristin Baker, PhD, presented results from the “BOOST” trial on November 16th.
In addition, recent ENACT graduate Molly Vaughan, PhD, DPT, presented her dissertation research to the ACR/ARHP audience. Her work, which analyzed data from the Multicenter Osteoarthritis Study (MOST) to examine, looked at the relationship between positive/negative affect and participation restriction among persons with knee osteoarthritis.
Did you miss these presentations? You can still find abstracts for all three talks here
We are excited to report that all three research projects supported by our Rehabilitation Research and Training Center (RRTC) grant through the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) have concluded data collection and final analyses are underway.
Through the diligent work of our center staff, our two RCTs achieved excellent retention, with both above 85% at 2-year follow up. In addition, we achieved high participation of underrepresented minorities (at nearly 30%) in both trials.
Continue below for project-specific updates:
Project 1 “Efficacy of a Modified Vocational Rehabilitation Intervention” (WORK-IT)–
Also called “Work-It”, our first of 2 randomized controlled trials investigated if a modified vocational rehabilitation intervention could affect work limitation outcomes among people with arthritis over two years of follow-up compared to people receiving a control intervention. Data collection concluded in December 2015 with the largest sample to date for an arthritis employment retention study! We anticipate disseminating primary results in 2016.
Project 2 “Can computer-based telephone counseling improve long-term adherence to strength training in elders with knee osteoarthritis?” (BOOST) –
Our second randomized controlled trial, the “BOOST” study, aimed to compare outcomes for participants with knee OA randomized to either a computer-based telephone counseling (TLC) or control group and determine whether or not TLC enhances adherence to and participation in exercise over 2 years. The study also aimed to determine the association of function and pain at 1 year and 2 years with adherence to the exercise program at the same time points. Data collection concluded in November 2015 and we anticipate disseminating primary results in 2016.
Project 3 “Community and Home Participation after Total Knee Replacement” –
ENACT’s third study, with both observational and qualitative arms, has concluded both data collection and analysis and results are being disseminated. This observational study aimed to explore home and community participation among persons with a total knee replacements at least 2 years to determine the risk factors associated with limited participation using the data from the Multicenter Osteoarthritis Study (MOST). The study also had a qualitative arm, which aimed to gain insight into people’s perceptions of factors that influence participation among people experiencing difficulties following a total knee replacement procedure. Two manuscripts are pending. PI Dr. Jessica Maxwell recently presented results from the qualitative arm of this study at the American Physical Therapy Association Combined Sections Meeting (APTA-CSM).
Look for upcoming manuscripts from ENACT and for presentations on these results and more at upcoming professional conferences in 2016!
ENACT’s spotlight for the March 2016 Newsletter features Dr. Kristin Baker, Principal Investigator for ENACT’s BOOST study. Dr. Baker’s background is in exercise physiology and nutritional science and her primary research interest lies in improving functional quality of life for people living with arthritis.
In her current position as a Research Assistant Professor in the Physical Therapy Department of Boston University’s Sargent College of Health and Rehabilitation Sciences, Dr. Baker is leading ENACT’s BOOST trial, a five-year project investigating how best to support people with arthritis to adhere to physical activity using existing technologies and behavioral science theory.
In the BOOST study, ENACT recruited 104 people with knee osteoarthritis to participate in a group strength-training program with 3 primary focuses: body alignment and mechanics, achieving the proper exercise intensity to improve muscle strength, and learning to progress through the exercises for continued improvement in muscle strength over time. After the group strength training program, participants were randomized to receive one of 2 follow-up interventions, a non-interactive automated message to remind participants to exercise or an automated interactive telephone system providing coaching and counseling information to promote continued exercise.
Though the benefits of physical activity to improve arthritis pain and function have been established and are widely accepted, adherence to exercise programs remains low among people with arthritis. According to Dr. Baker, if a telephone-based supportive technology proves to be effective for people with arthritis, it could be a cost-effective way to reach a wide range of people with rheumatic conditions, even potentially, “improving quality of life, and maybe prolonging the time before they need a knee replacement or reducing the number of doctor visits for medication.” In the long term, says Dr. Baker, it could have implications for the practice of physical rehabilitation by enabling patients to better adhere to therapeutic physical activity recommendations.
As technology continues to advance, the field of rehabilitation is recognizing and acting on the potential for technology to serve as a resource that may be modifiable for use in different populations, including those with rheumatic conditions. Dr. Baker’s ultimate goal would be to widely disseminate the technology used in the BOOST study, thus adding another resource to the technology toolbox for rehabilitation practitioners and researchers.
Data collection for this study was completed in late 2015 and the efficacy of the interactive telephone system is now being assessed. In addition, research assistant and ENACT doctoral fellow Aileen Ledingham received an ancillary grant to assess participant satisfaction with the system. Look for results to be released in Spring 2016!
To read more from Dr. Baker on the use of technology in rehabilitation, access the ENACT Presentation page here
ENACT’s site may look different, but the URL is the same!
The newly updated site features a cleaner design and updated look, simplified navigation to promote access to under-utilized areas of the site, and both updated and new content areas. It is now optimized for mobile platforms and features increased font size throughout the site for enhanced readability. We’ve expanded content areas on exercise and employment and created new content on the impact of community environment on participation, our work with the University of North Carolina-Chapel Hill on neighborhood walkability, and total knee replacement (TKR).
Please take a look around around our new site! Click here to redirect to the homepage
ENACT To Be Part of Boston University’s Free Virtual Conference HEALTH MATTERS on September 17th, 2015
Boston University's Sargent College of Health and Rehabilitation Sciences will hold Health Matters - a Virtual Conference on September 17th, 2015 from 9 am - 5 pm EST. The conference focuses on innovative research and clinical approaches in health and rehabilitation. Registration is required, but the event is free.
Speakers represent Sargent College faculty's range of health and rehabilitation professions, with an agenda that covers topics like communication neuroscience, human movement, traumatic brain injury, intensive language intervention, child development, and more. A feature of the work and experience of ENACT's doctoral fellows in the rehabilitation sciences doctoral program is scheduled for the 4:00 pm hour, just preceding ENACT collaborator Dr. Alan Jette's closing statement. See the full agenda here
To learn more about the conference or to register, click here
Today marks the 25 anniversary of the day that President George H.W. Bush signed into law the Americans with Disabilities Act (ADA). This landmark legislation guaranteed protection for people living with disabilities against discrimination in areas such as employment, public services, telecommunications, and transportation as well as provisions requiring reasonable accommodation in public and private settings.
The law is largely considered a civil rights victory for disabled Americans, enabling individuals with disabilities to assert his or her right to fully participate in and contribute to their communities. Learn more about how the ADA has affected the lives of Americans living with disabilities by exploring the ADA Legacy Project. Explore ENACT's arthritis-related resources to learn more about arthritis-related disability and work retention strategies.
ENACT is proud to announce that doctoral fellow Rawan AlHeresh, PhD, OT has successfully defended her dissertation and completed her course of study with the Sargent College of Health and Rehabilitation Science Doctor of Rehabilitation Science Program at Boston University.
Rawan first matriculated into ENACT's training program in July 2011. As our first doctoral fellow, it has been gratifying to watch her progress through the program and emerge as a competent scholar. We look forward to her upcoming contributions to the field of rheumatological rehabilitation.
Congratulations Dr. Rawan AlHeresh!
The presentation was given as part of Optimal Arthritis Management: Bridging Clinic to the Community, a 3-part symposia at February's American Physical Therapy Association-Combined Sections Meeting in Indianapolis, IN. The symposia was well-attended and feedback was enthusiastic. Fellow presenters included Mary Altpeter, MSW, PhD from the University of North Carolina's Center for Health Promotion and Disease Prevention and Lori Schrodt, PT, PhD from Western Carolina University