NCT05370118

Brief Summary

Individuals with mild cognitive impairment are often physically inactive and at risk for progressing to dementia. Physical inactivity is considered a modifiable risk factor for dementia. Therefore, interventions must be developed to foster sustainable improvement in daily physical activity. To address this problem, our pilot study aims are directed at assessing the feasibility and preliminary improvement of physical activity following the use of a mobile-health technology physical activity behavior change intervention. Similar interventions have shown to be very effective in older adults without cognitive impairment. We specifically focus on the subtype of amnestic mild cognitive impairment since this subtype often progresses to Alzheimer's Disease, a leading cause of death in the US. Improving physical activity is one approach to reduce the progression to Alzheimer's Disease and subsequently lower mortality. To increase the impact of the intervention, participants with amnestic mild cognitive impairment will be recruited along with a primary caregiver (dyads). Thirty dyads will be recruited and randomized to either an intervention group (15 dyads) or usual care group (15 dyads). The intervention group will receive a 12-week mobile-health technology physical activity behavior change intervention structured to improve physical activity. The intervention is unique in the combination of established behavior change theories and techniques and remote delivery for individuals with amnestic mild cognitive impairment. This pilot study is designed to assess the feasibility of the intervention by examining participant and primary caregiver retention, intervention session attendance, intervention acceptability and safety, and qualitative perspectives. Secondly, this pilot study will assess preliminary improvement in physical activity (i.e., daily steps). Improvement will be determined based on significant changes in participants' daily steps observed via accelerometry post-intervention in the intervention group compared to the usual care control group. The results of this study will support future work (K-award and R01 submissions) to explore efficacy and larger-scale implementation to reach rural and underserved areas of Nebraska and beyond.

Trial Health

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Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
60

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started Feb 2023

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 15, 2022

Completed
2 months until next milestone

First Posted

Study publicly available on registry

May 11, 2022

Completed
9 months until next milestone

Study Start

First participant enrolled

February 1, 2023

Completed
2.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2025

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2025

Completed
Last Updated

July 16, 2024

Status Verified

July 1, 2024

Enrollment Period

2.3 years

First QC Date

March 15, 2022

Last Update Submit

July 15, 2024

Conditions

Keywords

physical activitybehavior change

Outcome Measures

Primary Outcomes (5)

  • TPAB intervention Participant Retention

    The number of participants that complete the 12 week intervention will be calculated to determine participant retention.

    The outcome will be reported at the end of the 12 week intervention.

  • TPAB Intervention Attendance

    The number of weekly sessions attended across the 12-week intervention will be totaled to determine the TPAB Intervention Attendance.

    The outcome will be reported at the end of the 12 week intervention.

  • TPAB Intervention Acceptability

    The acceptability of the TPAB Intervention will be assessed by administering the Intrinsic Motivation Inventory Interest/Enjoyment Subscale at the conclusion of the intervention. The Intrinsic Motivation Inventory Subscale includes 7 statements that require the participant to respond on a 1-7 scale to the level they agree with the statement. The total score ranges from 7-49 with higher scores indicating greater Interest/Enjoyment.

    The outcome will be reported at the end of the 12 week intervention.

  • TPAB Intervention Safety

    The safety of the TPAB Intervention will be assessed by tracking and comparing the number of adverse events in the intervention and control group.

    The outcome will be reported at the end of the 12 week intervention.

  • Feasibility of the TPAB Intervention (Semi-Structured Interviews)

    Semi-structured interview will be conducted on the patient and caregivers that participated in the TPAB Intervention. Qualitative analysis will determine common themes in the responses.

    Semi-Structured Interviews will be conducted at the end of the 12 week intervention.

Secondary Outcomes (1)

  • Daily step count change

    Baseline and after the 12 week intervention

Study Arms (2)

Telerehabilitation physical activity behavioral (TPAB) intervention

EXPERIMENTAL

Individuals in the TPAB intervention will participate in a weekly session for 12 weeks with their primary caregiver and the research interventionist (RH). Established behavior-change techniques will be used in the TPAB intervention, based largely on the combination of the Social Cognitive Theory, Control Theory, and Operant Conditioning,43 including behavioral techniques, and patient-centered communication (e.g., motivational interviewing).44 The behavior-change techniques are designed to target and improve daily steps. Individuals in the CTL group will receive usual care and no intervention over the 12 weeks.

Behavioral: Telerehabilitation physical activity behavioral (TPAB) intervention

Control Group

NO INTERVENTION

Individuals in the CTL group will receive usual care and no intervention over the 12 weeks.

Interventions

The intervention includes the behavior change techniques of self-monitoring of behavior, action planning, graded tasks, restructuring the physical and social environment, problem-solving, and prompts/cues.

Telerehabilitation physical activity behavioral (TPAB) intervention

Eligibility Criteria

Age50 Years - 85 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • years old (patient); 19+ years (caregiver)
  • clinically diagnosed with amnestic MCI (patient only)
  • a score of 18-24 on the Montreal Cognitive Assessment indicating possible MCI (patient only),
  • not currently categorized as "Active" on the Rapid Assessment of Physical Activity, (patient only)
  • on stable doses of medication at least for the previous 30 days at baseline (patient only)
  • have a computer/wireless device with Internet access
  • have a primary caregiver willing to participate in physical activity and assist the patient with participation in the study
  • English-speaking

You may not qualify if:

  • limitations due to disability, illness, or pain that may affect the patient's walking safety during the study
  • unstable heart conditions (e.g., unstable angina, acute pericarditis)
  • uncontrolled hypertension in the last six months
  • known neurological diseases

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Creighton University

Omaha, Nebraska, 68178, United States

RECRUITING

MeSH Terms

Conditions

Cognitive DysfunctionCaregiver BurdenMotor Activity

Interventions

Methods

Condition Hierarchy (Ancestors)

Cognition DisordersNeurocognitive DisordersMental DisordersStress, PsychologicalBehavioral SymptomsBehavior

Intervention Hierarchy (Ancestors)

Investigative Techniques

Central Study Contacts

Rashelle Hoffman, PT, DPT, PhD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Masking Details
The outcomes assessors will be masked from the participant's treatment arm.
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: This pilot clinical research study is structured as a feasibility and preliminary efficacy trial to determine if the TPAB intervention is feasible and to compare daily step improvement between the TPAB intervention group and the CTL group. The trial is designed to inform a future larger-scale efficacy trial to assess longer time points for the sustainability of intervention impact.
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

March 15, 2022

First Posted

May 11, 2022

Study Start

February 1, 2023

Primary Completion

June 1, 2025

Study Completion

June 1, 2025

Last Updated

July 16, 2024

Record last verified: 2024-07

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