Browsing by Author "Guralnik, Jack M"
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- ItemEffect of a Home-Based Exercise Intervention of Wearable Technology and Telephone Coaching on Walking Performance in Peripheral Artery Disease: The HONOR Randomized Clinical Trial.(0000-00-00) McDermott, Mary M; Spring, Bonnie; Berger, Jeffrey S; Treat-Jacobson, Diane; Conte, Michael S; Creager, Mark A; Criqui, Michael H; Ferrucci, Luigi; Gornik, Heather L; Guralnik, Jack M; Hahn, Elizabeth A; Henke, Peter; Kibbe, Melina R; Kohlman-Trighoff, Debra; Li, Lingyu; Lloyd-Jones, Donald; McCarthy, Walter; Polonsky, Tamar S; Skelly, Christopher; Tian, Lu; Zhao, Lihui; Zhang, Dongxue; Rejeski, W JackImportance Clinical practice guidelines support home based exercise for patients with peripheral artery disease PAD but no randomized trials have tested whether an exercise intervention without periodic medical center visits improves walking performance Objective To determine whether a home based exercise intervention consisting of a wearable activity monitor and telephone coaching improves walking ability over 9 months in patients with PAD Design Setting and Participants Randomized clinical trial conducted at 3 US medical centers Patients with PAD were randomized between June 18 2015 and April 4 2017 to home based exercise vs usual care for 9 months Final follow up was on December 5 2017 Interventions The exercise intervention group n 99 received 4 weekly medical center visits during the first month followed by 8 months of a wearable activity monitor and telephone coaching The usual care group n 101 received no onsite sessions active exercise or coaching intervention Main Outcomes and Measures The primary outcome was change in 6 minute walk distance at 9 month follow up minimal clinically important difference MCID 20 m Secondary outcomes included 9 month change in subcomponents of the Walking Impairment Questionnaire WIQ 0 100 score 100 best SF 36 physical functioning score Patient Reported Outcomes Measurement Information System PROMIS mobility questionnaire higher better MCID 2 points PROMIS satisfaction with social roles questionnaire PROMIS pain interference questionnaire lower better MCID range 3 5 4 5 points and objectively measured physical activity Results Among 200 randomized participants mean SD age 70 2 10 4 years 105 52 5 women 182 91 completed 9 month follow up The mean change from baseline to 9 month follow up in the 6 minute walk distance was 5 5 m in the intervention group vs 14 4 m in the usual care group difference 8 9 m 95 CI 26 0 to 8 2 m P 31 The exercise intervention worsened the PROMIS pain interference score mean change from baseline to 9 months was 0 7 in the intervention group vs 2 8 in the usual care group difference 3 5 95 CI 1 3 to 5 8 P 002 There were no significant between group differences in the WIQ score the SF 36 physical functioning score or the PROMIS mobility or satisfaction with social roles scores Conclusions and Relevance Among patients with PAD a home based exercise intervention consisting of a wearable activity monitor and telephone coaching compared with usual care did not improve walking performance at 9 month follow up These results do not support home based exercise interventions of wearable devices and telephone counseling without periodic onsite visits to improve walking performance in patients with PAD Trial Registration clinicaltrials gov Identifier NCT02462824
- ItemMobile Diabetes Intervention for Glycemic Control in 45- to 64-Year-Old Persons With Type 2 Diabetes.(2016-01-05) Quinn, Charlene C; Shardell, Michelle D; Terrin, Michael L; Barr, Erik A; Park, DoHwan; Shaikh, Faraz; Guralnik, Jack M; Gruber-Baldini, Ann LThe purpose of this study was to assess effects of a mobile coaching system on glycated hemoglobin HbA1c levels in younger versus older patients over 1 year Participants n 118 included adult patients with Type 2 diabetes cared for by community physicians Intervention patients received mobile phone coaching and individualized web portal Control patients received usual care Patients were stratified into two age groups younger Under55 years and older 55 years The intervention resulted in greater 12 month declines in HbA1c compared with usual care for patients in both age groups p Under 0001 Among older patients HbA1c changed by 1 8 95 confidence interval CI 2 4 1 1 in the intervention group and 0 3 95 CI 0 9 0 3 in the control group Among younger patients HbA1c changed by 2 0 95 CI 2 5 1 5 in the intervention group and 1 0 95 CI 1 6 0 4 in the control group The mobile health intervention was as effective at managing Type 2 diabetes in older adults as younger persons