A physiotherapist-delivered, combined exercise and pain coping skills training intervention for individuals with knee osteoarthritis : A pilot study
Hunt, Michael Keefe, Francis Bryant, Christina Metcalf, Ben Ahamed, Yasmin Nicholas, Michael Bennell, Kim
Hunt, Michael
Keefe, Francis
Bryant, Christina
Metcalf, Ben
Ahamed, Yasmin
Nicholas, Michael
Bennell, Kim
Abstract
Background: Osteoarthritis (OA) of the knee is associated with a number of physical and psychological impairments. Unfortunately, very few treatment strategies are capable of addressing both types of impairments concurrently. We performed a pilot, randomized controlled, proof of principle trial investigating the feasibility and effects of an intervention combining physical exercise and pain coping skills training (PCST).
Methods: Twenty patients with a clinical and radiographical diagnosis of tibiofemoral OA were randomized to receive either 10 weeks of physiotherapist supervised exercises (lower limb strengthening and walking) combined with non-directive counseling (NDC) or the same exercise program delivered concurrently with PCST. Primary outcomes included self-reported pain and pain coping, while secondary outcomes included self efficacy and self-reported physical function.
Results: Ten participants were randomized to each group and both groups exhibited significant improvements in isometric knee strength, self-reported knee pain and physical function, self efficacy for control of pain management and other arthritis symptoms. Only those in the exercise + PCST group reported statistically significant improvements in pain control coping and rational thinking. No between-group differences existed in any outcome (0.07 < p < 0.98). Based on our findings, 63 participants per group would be needed for future large-scale studies using similar outcome measures and design.
Conclusions: Our study showed that an intervention that combines exercise and PCST within the same treatment session and delivered by specially-trained physiotherapists is feasible and can improve both physical and psychological outcomes in individuals with knee OA.
Level of evidence Level II: Clinical Trials Registry number: ACTRN12609000623291
Keywords
Date
2013
Type
Journal article
Journal
The Knee
Book
Volume
20
Issue
2
Page Range
106-112