A physiotherapist-delivered, combined exercise and pain coping skills training intervention for individuals with knee osteoarthritis : A pilot study
Hunt, M., Keefe, F., Bryant, C., Metcalf, B., Ahamed, Y., Nicholas, M. & Bennell, K. (2013). A physiotherapist-delivered, combined exercise and pain coping skills training intervention for individuals with knee osteoarthritis : A pilot study. The Knee,20(2), 106-112. Retrieved from https://doi.org/10.1016/j.knee.2012.07.008
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
Mary MacKillop Institute for Health Research