Polymyalgia Rheumatica (PMR)
Conditions
Keywords
rehabilitation, physical therapy
Brief summary
Polymyalgia rheumatica (PMR) is a condition that causes joint pain and stiffness, making it hard for people to do everyday tasks. Movement pattern training is a special, personalized rehabilitation program that aims to reduce pain by improving how people move during their daily activities. The investigators plan to test if it's possible to conduct a detailed study to find out how effective Movement pattern training is for people with PMR. The investigators will look at whether it helps them perform activities they want to do, reduce their use of certain medications, and strengthen their muscles. The investigators will also gather feedback from patients about their experience with Movement pattern training. This study will help us understand if carrying out a larger study on Movement pattern training's effectiveness is practical.
Interventions
BEHAVIORALMovement Pattern Training (MoveTrain)
6 individualized treatment sessions over 10 weeks * Motivational interviewing to determine personal goals and strengthen motivation and commitment to change * Activity-specific training to practice modified motion during patient-specific tasks, defined as activities reported by each patient as pain-provoking * Home exercise program 3 times/week consisting of activities or exercises assigned in the supervised sessions * Patient's independence and adherence in performing home exercise program will be documented * Patients are encouraged to use modified motion during daily and physical activities * Based on patient performance, activity difficulty is progressed by increasing repetitions performed or increasing load or speed
OTHERUsual Care
* Basic education about polymyalgia rheumatica, benefits of physical activity * Patients will be encouraged to participate in physical activity as tolerated * Medication as prescribed by their physician
Sponsors
Washington University School of Medicine
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
DOUBLE (Investigator, Outcomes Assessor)
Intervention model description
The study design is a feasibility randomized clinical trial to assess our ability to complete a larger clinical trial to compare movement pattern training (personalized rehabilitation) compared to usual care.
Eligibility
Sex/Gender
ALL
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patient reports a diagnosis or flare of polymyalgia rheumatica (PMR) \< 5 months before the screening contact * Diagnosis or flare of PMR according to the European League against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria as follows (must satisfy all criteria)10: * Age ≥50 years at time of diagnosis * Presence of bilateral shoulder pain * Elevated acute phase reactants C-reactive protein (CRP) \>10 milligram/Liter and/or Erythrocyte Sedimentation Rate (ESR) \>30 millimeters/hour\* * A score ≥4 at the time of diagnosis based on the following (without ultrasound): * Duration of morning stiffness \>45 minutes: 2 points * Hip pain or limited range of motion: 1 point * Seronegative for rheumatoid factor and anti-cyclic citrullinated peptide: 2 points * Absence of other joint involvement: 1 point * Initiated pharmacological treatment * Able to give informed consent * Physician's clearance to participate in physical activity
Exclusion criteria
* Diagnosis of fibromyalgia, neuropathic muscular disease, complex regional pain syndrome, or small fiber neuropathy * planned major surgical procedure during the study * Current active uncontrolled infection
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of potential participants accessed. | 7 months | The total number of people with Polymyalgia rheumatica (PMR) who were recruited each week |
| Percent of eligible participants who were willing to be randomized | 7 months | Percent of eligible participants are willing to be randomized during the study |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Preliminary estimates of change in polymyalgia rheumatica impact scale (PMR-IS) | From enrollment to the end of treatment at 10 weeks | The change in polymyalgia rheumatica impact scale (PMR-IS), a self-report questionnaire specific to polymyalgia rheumatica, that represents the patients symptoms and functional ability. |
| Preliminary estimates of change in physical activity | From enrollment to the end of treatment at 10 weeks | The change in physical activity as represented by the Stanford 7-DAy Physical Activity Recall survey |
| Preliminary estimates of change in cumulative glucocorticoid dose | From enrollment to the end of treatment at 10 weeks | Change in cumulative glucocorticoid dose assessed by patient's self-report logs |
| Preliminary estimates of change in muscle strength | From enrollment to the end of treatment at 10 weeks | change in muscle strength of the hips and shoulders, assessed using a hand dynamometer |
Contacts
CONTACTMarcie Harris-Hayes, DPT, MSCI
Outcome results
None listed