Setting out to prove that movement indeed is medicine for older adults with chronic knee and hip pain, Wake Forest University researchers have received a $5.7 grant from the National Institutes of Health (NIH) to conduct a five-year study.
The Mobile Intervention to Reduce Pain and Improve Health-III (MORPH-III) study will track how adults age 65 or older living with obesity respond to six months of physical activity and nutrition coaching - and how much the intervention reduces weight and curbs chronic pain.
NIH reports that 65 percent of adults in the U.S. said they suffered from pain, while the Centers for Medicaid and Medicare Services reported that 78 percent of Medicare enrollees said they lived with chronic pain, making research such as MORPH-III vital as the population ages.
“We have found that adding lifestyle behavior changes is a sort of magical thing with this population - they can manage their pain, and feel more lively and engaged in their life,” said co-principal investigator Jason Fanning, assistant professor of health and exercise science at Wake Forest University.
Fanning has studied how to use mobile apps to foster social support among peers and coach older adults to lose weight. The first MORPH study began recruiting in 2017, and results from the pilot study and related research have been published in peer-reviewed journals including Frontiers in Digital Health, Obesity and The Journals of Gerontology.
Finding ways to decrease pain without medications is even more important in this age group, because older adults suffer more from side effects.
“Many older adults are susceptible to the side effects of pain medications, both non-opioid and opioid, because of coexisting chronic conditions like kidney disease,” said co-principal investigator Dr. Amber Brooks, associate professor of anesthesiology at Wake Forest University School of Medicine.
The MORPH pilot studies had several goals, including decreasing sedentary behavior, encouraging movement that participants enjoyed throughout the day and understanding how the MORPH mHealth app and activity monitor could help them increase activity and lose weight.
Building on that research, MORPH-III will recruit 200 older adults living with obesity primarily in North Carolina and southern Virginia. Participants must have knee or hip osteoarthritis and live independently.
Participants will be divided randomly into two groups, with all interventions delivered remotely:
- “MORPH,” group participants will attend one weekly group session plus receive individual coaching calls for six months. Their goal is to increase daily steps by moving often throughout the day, using an activity monitor and the mHealth app to view feedback and set goals. They also will also try to lose weight through healthy eating and calorie reduction.
- “Measurement,” group participants will receive an activity monitor and wireless weight scale.
Researchers will check in with the participants again at 18 months to see if the lifestyle changes have continued to make a difference, even after active coaching has ended.
MORPH-III also adds a collaborative community advisory board, which aims to help the researchers ensure study participants are recruited from a variety of backgrounds and circumstances. The board will review recruiting materials as well as study technologies and other program materials, and offer feedback with that goal in mind.
“Collaborations between health and exercise science researchers from the Reynolda Campus and Wake Forest University School of Medicine have incredible potential to improve health outcomes,” said Kim McAllister, Wake Forest’s Vice Provost for Research, Scholarly Inquiry and Creative Activity.
Fanning said the ultimate goal is to develop a program that helps older adults move more, lose weight, reduce pain and maintain weight loss for the long term—and that can be administered by community organizations such as senior centers and businesses.
Recruiting for MORPH-III should begin in January 2025.
The research is supported by the National Institute on Aging of the National Institutes of Health under Award Number R01AG082777.
Media contacts: Cheryl Walker, Wake Forest University, walkercv@wfu.edu; Myra Wight, Wake Forest University School of Medicine, mgwright@wakehealth.edu