Osteoarthritis, Knee
Conditions
Keywords
pain neuroscience education, knee, osteoarthritis
Brief summary
The aim of Pain Neuroscience Education (PNE) is to explain to patients the biological and physiological processes involved in a pain experience and, more importantly, defocus the issues associated with the anatomical structures. PNE provides compelling evidence in reducing pain, disability, pain catastrophization, and limited physical movement in musculoskeletal problems. Knee osteoarthritis (KOA) is a very common painful musculoskeletal problem, especially in people over 50 years old, and lead to decrease in knee range of motion. Despite costly arthroscopic surgeries and long-term physiotherapy treatments, poor outcomes are common. The lack of satisfactory results suggests that some practices should be revised. Although PNE could be useful as an intervention, to our knowledge, there is no randomized controlled trial in the literature investigating the effects of PNE in patients with a KOA. Therefore, we aimed to examine the effectiveness of PNE on clinical outcomes in patients with KOA.
Interventions
OTHERPain Neuroscience Education
The experimental group will follow a PNE protocol based on previous procedure for 6 weeks in addition to the standard physiotherapy program (SPP) in postoperative period. Each PNE session will take 45-60 min. PNE will be conducted in line with international guidelines and covered the neurophysiology of pain, transition from acute to chronic pain, and the nervous system ability to modulate the pain experience.
OTHERStandard Physiotherapy Program (SPP)
The control group will follow a SPP. The 45-minute-long treatment sessions will be held 5 days per week. The treatment program will be organized in 3 periods as 0-2 weeks, 3-4 weeks and 5-6 weeks. The overall treatment program will include scar massage, patellar mobilization, coldpack, ankle pump, quadriceps and hamstring strengthening, hip range of motion, hip strengthening exercises, squat, ascending and descending stairs, walking training. All exercises will be 10 repetitions x 2 sets.
Sponsors
Ahi Evran University Education and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
the blinded assessor
Intervention model description
Randomized
Eligibility
Sex/Gender
ALL
Age
40 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Having a body mass index between 19-40 kg/m2, * Having had a unilateral TKA, * Knee pain score to be 4 and above daily according to the visual analog scale, * Ability to read, speak and understand Turkish.
Exclusion criteria
* Prosthesis disorders requiring re-surgery, * Having visual, auditory and cognitive impairment, * Secondary TKA such as rheumatoid arthritis, * Acute pain, * Pregnancy, drug and alcohol use, * Having bilateral TKA, * Not volunteering to participate in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain severity | Baseline | Visual Analogue Scale (0-10, higher means worse) |
| Pain severity change is being assessed | 6 week | Visual Analogue Scale (0-10, higher means worse) |
| Pain and Function | Baseline | Knee Injury and Osteoarthritis Outcome Score (0-100, higher means better) |
| Pain and Function change are being assessed | 6 week | Knee Injury and Osteoarthritis Outcome Score (0-100, higher means better) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Anxiety and Depression change is being assessed | 6 week | Hospital Anxiety Depression Scale (0-21, higher means worse) |
| Physical Function | Baseline | 40 meter walking test (in seconds, less is better) |
| Kinesiophobia | Baseline | Tampa Scale of Kinesiophobia (17-68, higher means worse) |
| Kinesiophobia change is being assessed | 6 week | Tampa Scale of Kinesiophobia (17-68, higher means worse) |
| Pain Catastrophizing change is being assessed | 6 week | Pain Catastrophizing Scale (0-52, higher means worse) |
| Physical Function change is being assessed | 6 week | 40 meter walking test (in seconds, less is better) |
| Pain Catastrophizing | Baseline | Pain Catastrophizing Scale (0-52, higher means worse) |
| Level of quality of life | Baseline | Short Form-12 (0-100, higher means better) |
| Level of quality of life change is being assessed | 6 week | Short Form-12 (0-100, higher means better) |
| Anxiety and Depression | Baseline | Hospital Anxiety Depression Scale (0-21, higher means worse) |
Countries
Turkey (Türkiye)
Outcome results
None listed