None listed
Conditions
Brief summary
Whilst most patients are satisfied with their outcomes after a total knee replacement, moderate to severe persistent knee pain, defined as pain persisting beyond 3 post-operative months following surgery, can affect 25% of people at 6-months. NJ’s PhD studies have found associations of persistent high pain with reduced function, and reduced health related quality of life. Other studies have found that pain persisting after a knee replacement can interfere with walking, general activity and mood and reduced quality of life. A literature review conducted as part of NJ’s PhD (unpublished) found no rehabilitation programs addressing persistent pain after knee replacement. NJ, during his PhD studies, has designed a web-based, self-paced, pain rehabilitation program called Kneed to treat pain, reduced function and reduced quality of life for those with persistent pain after total knee replacement for osteoarthritis. The program consists of pain neuroscience education, exercise, motor imagery, desensitization techniques, relaxation, sleep and cognitive strategies such as goal setting. Educational and other strategies aim to normalize movement patterns (by reducing protective movements) and engage participants in functional activities by empowering behavior change. Kneed is being evaluated for the first time in a research study but has been used by patients under clinical supervision from Dr NJ (a Rehabilitation Physician) in a clinical practice. The potential benefit of Kneed as a digital health solution is to provide low-cost treatment to a broad audience, not limited by location (for example, rural areas and cities without pain management services). There are currently no evidence-based treatments available for this persistent pain condition, Kneed aims to provide one.
Interventions
Kneed group participate in an 8-week self-paced online pain rehabilitation program of education, exercise and strategies to treat pain, reduced function, dysfunctional sleep and stress. The program has been developed by NJ, a Rehabilitation Physician with 20 years + experience in treating pain. Kneed is unsupervised and is entirely online. It consists of written information, downloadable programs, quizzes and videos providing pain neuroscience education and strategies to self-manage pain. There
Kneed group participate in an 8-week self-paced online pain rehabilitation program of education, exercise and strategies to treat pain, reduced function, dysfunctional sleep and stress. The program has been developed by NJ, a Rehabilitation Physician with 20 years + experience in treating pain. Kneed is unsupervised and is entirely online. It consists of written information, downloadable programs, quizzes and videos providing pain neuroscience education and strategies to self-manage pain. There are two introductory modules that take 30 minutes and then Participants can choose which modules they wish to do. Exercise is taught to be self-paced and is low to medium intensity, the time spent doing exercise is encouraged to be 30 minutes a day as a goal (usually walking). There are videos demonstrating balance, strength and range of motion exercises for the knee. It is limited to people living in Australia with internet access. Adherence is not monitored but there is a downloadable goal sheet for exercise and functional activities chosen by the participant. Strategies for pain include pacing, exercise, sleep management, relaxation, progressive muscular relaxation, goal setting and motor imagery. The program is not personalised.
Sponsors
Epworth Monash Rehabilitation Medicine Unit
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Persistent pain > 3/10 on Numerical Rating Scale in index knee >3 months after total knee replacement for osteoarthritis internet access and email
Exclusion criteria
History of rheumatoid or other inflammatory arthritis Likely to undergo knee or other surgery in the next 3 months Active illness from any medical condition that makes exercise potentially unsuitable such as unstable angina Inability to walk within their household
Outcome results
None listed