Rehabilitation for Arthritis of The Knee: mainTaining Improvement for Veterans
ReAKTIV
A Remotely - Applied Behaviorally- Designed Intervention Incorporating Gamification, Social Incentives, and Health Coaching to Improve Durability of Physical Therapy for Knee Osteoarthritis (ReAKTIV)
2 other identifiers
interventional
254
1 country
5
Brief Summary
The aims are to determine whether 1) an incentive based on behaviorally-enhanced gamification and social incentives and 2) health coaching can promote adherence to exercise and physical activity after physical therapy for osteoarthritis of the knee (KOA). The research design is a randomized clinical trial with factorial design This randomized clinical trial of 254 patients using a factorial design will leverage a clinical trial platform developed through the University of Pennsylvania that allows for the remotely capture important patient-reported outcomes and other interaction through a participant's smart phone. The investigators will randomize participants to receive social incentives with gamification to promote adherence to prescribed exercises as well as maintenance of greater levels of physical activity and compare to controls that receive a Fitbit but no additional incentive. Participants may also be randomized to receive a health coach. The investigators will utilize mobile applications for smart phones and wearable activity trackers through the Way-to-Health platform and assess, in real time, the impact of the interventions on patient-reported function and pain (as measured by the Knee Osteoarthritis Outcome Score) as well as physical activity. Participants will be followed for 2 years, with a total of 5 in-person visits. Knee osteoarthritis (KOA) is one of the most prevalent and disabling conditions among Veterans and accounts for high morbidity and high costs for the VA. Importantly, while physical therapy is valuable for patients with KOA, lack of adherence to home exercises and low overall physical activity limit the durability of response. The current proposal aims to address two important knowledge gaps in the management of KOA in order to improve pain and function.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P50-P75 for phase_3
Started Dec 2025
Typical duration for phase_3
5 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
June 28, 2024
CompletedFirst Posted
Study publicly available on registry
July 5, 2024
CompletedStudy Start
First participant enrolled
December 10, 2025
CompletedPrimary Completion
Last participant's last visit for primary outcome
May 31, 2029
ExpectedStudy Completion
Last participant's last visit for all outcomes
January 1, 2030
January 8, 2026
January 1, 2026
3.5 years
June 28, 2024
January 6, 2026
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
KOOS (Knee Osteoarthritis Outcome Score)
The KOOS score is a validated and widely used measure of knee-related pain and physical functioning that has been validated in both knee injury and KOA populations. The KOOS measures symptoms and disability on five subscales: Pain, other Symptoms, Function in Activities of Daily Living, Function in Sports and Recreation, and Quality of Life (QOL). Range is from 0-100 for each subscale with lower scores suggesting worse patient experience.
all available measures between 6-18 months (time-averaged effect)
Secondary Outcomes (5)
Average Daily Step Counts
0-18 Months
Change in Self Efficacy for excercise
6-18 months
Change in gait speed
6-18 months
30 second sit-to-stand
6-18 months
Patient Reported Outcomes Measurement Information System Pain Intensity
6-18 Months
Study Arms (4)
No Intervention
NO INTERVENTIONNeither Intervention
Health Coaching, No Incentives
EXPERIMENTALReceives a Health Coach but no Incentive Program
No Health Coach, Receives Incentives
EXPERIMENTALDoes not receive a health coach but does receive the incentive program.
Health Coaching, Receives Incentives
EXPERIMENTALReceives both a health coach and the incentive program
Interventions
Health Coaching
Behavioral incentive program including gamification, social incentivization, and monitoring.
Eligibility Criteria
You may qualify if:
- Clinical diagnosis or chronic knee osteoarthritis.
- Age between 40-90 years
- Initiating physical therapy for KOA (has initial appointment within the next month or had first PT visit within the last 7 days)
- To be randomized: PT feels that they are able to safely and reliably participate in ongoing exercise.
- To be randomized: must have completed at least 4 virtual or in-person appointments with PT
- To be randomized: must sync their Fitbit at least monthly.
You may not qualify if:
- Lack of a smart phone allowing interaction with the WTH platform
- Inability to walk 2 blocks without assistance
- Poorly controlled crystalline arthritis or other diagnosis of inflammatory arthritis.
- Treating provider or LSI believes life-expectancy is \<1 year
- Severe pain in a non-knee area limiting daily function
- Non-English speakers or poor reading ability limiting ability to interact with text messages.
- Pregnancy
- Receiving physical therapy outside of the VA.
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (5)
Birmingham VA Medical Center, Birmingham, AL
Birmingham, Alabama, 35233-1927, United States
Omaha VA Nebraska-Western Iowa Health Care System, Omaha, NE
Omaha, Nebraska, 68105-1850, United States
VA Portland Health Care System, Portland, OR
Portland, Oregon, 97207-2964, United States
Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA
Philadelphia, Pennsylvania, 19104-4551, United States
VA Puget Sound Health Care System Seattle Division, Seattle, WA
Seattle, Washington, 98108-1532, United States
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Joshua F. Baker, MD MSCE
Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- phase 3
- Allocation
- RANDOMIZED
- Masking
- NONE
- Purpose
- TREATMENT
- Intervention Model
- FACTORIAL
- Sponsor Type
- FED
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
June 28, 2024
First Posted
July 5, 2024
Study Start
December 10, 2025
Primary Completion (Estimated)
May 31, 2029
Study Completion (Estimated)
January 1, 2030
Last Updated
January 8, 2026
Record last verified: 2026-01
Data Sharing
- IPD Sharing
- Will not share