Digital Home-Based Physical Activity Promotion for Older Adults After Total Hip Arthroplasty

Summary

The goal of this clinical trial is to evaluate the efficacy of a 12-week digital home-based intervention program, consisting of a tablet-based exercise program with or without personal coaching, to promote physical activity (PA) in older adults after total hip arthroplasty (THA). The main question it aims to answer is:

• Does the combination of the digital exercise program and personal coaching lead to higher PA six months after THA compared to usual care among older adults?

Secondary questions are:

* Does the digital exercise program alone lead to higher PA compared to usual care?
* Does the digital exercise program combined with personal coaching lead to higher PA compared to the exercise program alone?

Participants' PA will be objectively measured with a body-fixed sensor at 1 week before THA (T1), 6 weeks after THA (T2), and 6 months (i.e. after THA (T3). After the postoperative assessment at T2, participants will be randomly assigned to one of three groups:

* 12-week tablet-based exercise program at home with virtual personal coaching for physical activity promotion
* 12-week tablet-based exercise program at home
* Usual care (control group, no additional intervention)

Conditions

• Total Hip Arthroplasty (THA)
• Older Adults (65 Years and Older)

Interventions

BEHAVIORAL

Digital exercise program

KOKU is a digital adaptation of the evidence based Otago Exercise Program and Falls Management Exercise program, both designed to improve strength, balance, and reduce fall risk in older adults. KOKU includes 26 balance and strength exercises of varying difficulty. Each exercise is accompanied by written and audio instructions for safe performance and is demonstrated by a virtual trainer. Training sessions consist of three exercises suggested by the KOKU app, which participants are encouraged to perform for as many repetitions as possible until fatigue. Progression is guided by the participant's subjective assessment of effort and difficulty. Participants may choose to perform any exercise at any time, regardless of the app-suggested sequence. The KOKU app also provides reminders to exercise if no activity is detected for two days.

BEHAVIORAL

Personal coaching for physical activity promotion

Personal coaching consists of three video calls conducted via the study tablet by staff trained in BCTs and motivational communication skills. Participants receive a low cost, wrist worn activity tracker during the initial home visit to support self-monitoring and provide feedback on PA behavior. The first virtual coaching session (week 2) focuses on goal setting and action planning, the second session (week 3) addresses identification and management of barriers, and the third session (week 12) serves as a booster to review and adjust activity goals for the post intervention period.

Sponsors & Collaborators

• Geriatric Center, Heidelberg University

  collaborator UNKNOWN

• Heidelberg University - Institute of Medical Biometry (IMBI)

  collaborator UNKNOWN

• Heidelberg University

  lead OTHER

Principal Investigators

• Tobias Reiner, PhD, MD · Department of Orthopaedics, Heidelberg University Hospital

• Christian Werner, PhD · Geriatric Center, Heidelberg University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

65 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-09-30

Primary Completion

2028-01-31

Completion

2028-01-31

Countries

• Germany

Study Locations