Knee osteoarthritis
Conditions
Interventions
The experimental intervention will be a model of stratified exercise therapy for PTs. This model consists of a stratification tool and subgroup-specific, protocolized exercise therapy. Based on the st
Sponsors
VU Amsterdam, Department of Health Sciences
Eligibility
Inclusion criteria
Inclusion criteria: - knee pain (NRS during walking >= 2/10) persisting for at least 3 months as their reason to visit the PT; - clinical diagnosis of knee OA according to the criteria of the American College of Rheumatology, assessed by the PT, which is: knee pain and at least three of the following six items: age ≥ 45 years; morning stiffness < 30 minutes; crepitations; bone sensitivity; bony enlargement of the joint margin; no palpable warmth; - providing informed consent.
Exclusion criteria
Exclusion criteria: - age 85 years; - severe knee pain (i.e., NRS pain severity during walking >= 9/10); - physical or mental comorbidity severely affecting daily life and a contraindication for the usage of exercise therapy; - suspicion of chronic widespread pain (i.e., pain present for at least three months in at least three joints including left and right side of the body, above and below the waist and the axial skeleton); - presence of total knee arthroplasty (TKA) or on waiting list for TKA; - other reasons for knee pain than knee OA (e.g., rheumatoid arthritis, gout) - received PT or intra-articular injections in past 6 months because of knee pain; - insufficient comprehension of Dutch language.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| - Knee pain severity, assessed by a Numeric Rating Scale (NRS) for knee pain on average during walking in the past week (1 item; score between 0 and 10; 0= no pain; 10= worst pain imaginable). - Physical functioning, assessed by subscale function in daily living (ADL) of the Dutch translation of the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire (17 items; score between 0 and 100; 0= maximal problems; 100= no problem) | — |
Secondary
| Measure | Time frame |
|---|---|
| - Global perceived effect (GPE; 1 item). This item measures the patient’s subjective global improvement using a 7-point scale ranging from ‘worse than ever’ to ‘completely recovered’. This measure will be dichotomized as follows: recovered (‘completely recovered’ and ‘much recovered’) vs. not recovered (all other responses). - Physical functioning, assessed by the short version of the Dutch translation of the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire (7 items, from which 4 items are already included in the KOOS-ADL (primary outcome measure; score between 0 and 100; 0= maximal problems; 100= no problem). - Pain interference, assessed by the short version of the Patient Reported Outcomes Measurement Information System (PROMIS) - Pain interference (4 items) - Fatigue, assessed by the short version of the Patient Reported Outcomes Measurement Information System (PROMIS) - Fatigue (4 items) - Patient-reported knee instability (3 items: frequency of episodes of knee instability in the past 3 months, impact of knee instability on daily living, and knee joint involved). - Upper leg muscle strength, assessed by the 30-second chair stand test (30sec-CST).This performance test measures the maximum number of chair stand repetitions possible in a 30 second period, and is considered a measure of lower body strength as well as a performance-based measure for physical functioning - Body mass index (BMI): body weight (in kilogram) divided by squared body length (in meters). - Waist circumference: distance around the abdomen in the horizontal plane midway between the lowest rib and the iliac crest. - Economic evaluation: cost questionnaire (17 items), including intervention-related costs, other healthcare costs (including informal care), costs related to work (only for patients that are not yet retired), work-related absenteeism and presenteeism, work ability, and unpaid productivity. - Economic evaluation: QALYs, assessed by the EuroQol-5D-5L (EQ-5 | — |
Contacts
Public ContactJesper Knoop
Vrije Universiteit Amsterdam
Outcome results
None listed