Group Physical Therapy Classes for Osteoarthritis Pain

Recruiting in Palo Alto (17 mi)

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: University of Missouri-Columbia

Disqualifiers: Pregnant, Prisoners

No Placebo Group

Approved in 3 Jurisdictions

Trial Summary

What is the purpose of this trial?

The primary objective of this study is to study how low-impact group exercise classes affect pain scores in patients with knee, hip, and ankle pain when paired with concurrent standard of care dietitian and behavioral health consults.

Do I have to stop taking my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Group Physical Therapy Classes for Osteoarthritis Pain?

Research shows that group physical therapy programs for knee osteoarthritis can improve pain and function as effectively as individual therapy, while also being more efficient. Additionally, a group exercise program for knee osteoarthritis has been found to significantly reduce pain and improve physical function and walking ability. ^{1 2 3 4 5}

Is group physical therapy safe for humans?

Research shows that group physical therapy, including exercise programs for conditions like osteoarthritis and low back pain, is generally safe for humans. These programs have been compared to individual therapy and found to provide similar or better outcomes without additional safety concerns. ^{1 4 6 7 8}

How is the Group Physical Therapy Classes treatment for osteoarthritis pain different from other treatments?

Group Physical Therapy Classes for osteoarthritis pain are unique because they offer similar or better improvements in pain and function compared to traditional one-on-one physical therapy, while using fewer clinician hours per patient. This makes it a more efficient option for managing the high prevalence of knee osteoarthritis. ^{1 4 9 10 11}

Research Team

Eligibility Criteria

This trial is for adults over 18 with knee, hip, or ankle pain who can attend low-impact exercise classes three times a week for six months and also go to dietitian and behavioral health sessions. It's not open to prisoners or pregnant individuals.

Inclusion Criteria

I can attend diet and mental health classes for 6 months.

I am 18 years old or older.

I can attend classes 3 times a week for 6 months and maintain at least a 66% attendance.

Exclusion Criteria

You are pregnant.

Prisoners

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in low-impact group exercise classes three times weekly, paired with dietitian and behavioral health consults

6 months

3 visits per week (in-person)

Follow-up

Participants are monitored for changes in BMI and VAS pain scores after the treatment phase

4 weeks

Treatment Details

Interventions

• Group Physical Therapy Classes (Behavioural Intervention)

Trial Overview The study tests if low-impact group exercise classes combined with standard care from dietitians and mental health professionals can reduce joint pain in the knee, hip, or ankle.

Participant Groups

Group I: Group Physical Therapy Class Experimental Treatment 1 Intervention

Group Physical Therapy Classes. Three times weekly, these subjects will have one hour group physical therapy sessions with either a physical therapist, physical therapy assistant, or personal trainer. These sessions will be aimed to improve strength and function in a low-impact setting designed specifically for those with joint pain.

Group Physical Therapy Classes is already approved in Canada for the following indications:

Approved in Canada as Low-Impact Exercise Programs for:

• Chronic pain management
• Musculoskeletal health
• Rehabilitation services

Who Is Running the Clinical Trial?

University of Missouri-Columbia

Lead Sponsor

Trials

387

Recruited

629,000+

Mun Y. Choi

University of Missouri-Columbia

Chief Executive Officer since 2017

PhD in Mechanical and Aerospace Engineering from Princeton University

Richard Barohn

University of Missouri-Columbia

Chief Medical Officer since 2020

MD from the University of Missouri-Columbia School of Medicine

Findings from Research

Group physiotherapy after joint replacement surgery resulted in similar recovery outcomes as individualized home physiotherapy, with no significant differences in key measures like pain and function at 12 weeks post-surgery.

The group physiotherapy approach was more time-efficient, allowing patients to receive more frequent sessions while requiring less time from physiotherapists per visit, making it a cost-effective option without compromising patient care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Group physiotherapy provides similar outcomes for participants after joint replacement surgery as 1-to-1 physiotherapy: a sequential cohort study. Coulter, CL., Weber, JM., Scarvell, JM.[2009]

Physical therapists must effectively track outcomes for patients with low back pain to monitor treatment effectiveness, and this article reviews various measurement tools to aid in that process.

The article discusses the reliability and validity of common outcome measures, such as the SF-36 and Oswestry Questionnaire, providing practical guidelines for their selection and use in clinical practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Guide to outcomes measurement for patients with low back pain syndromes. Resnik, L., Dobrzykowski, E.[2019]

The Group Physical Therapy (PT) program for knee osteoarthritis showed clinically relevant improvements in pain and function, with WOMAC scores decreasing from 56.8 to 46.9 and chair rise test performance increasing from 10.4 to 11.9 rises in 30 seconds among participants who completed the program.

Despite these positive outcomes, attendance and completion rates were lower than ideal, indicating a need for program adaptations to enhance participation and effectiveness in future implementations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Implementation of a group physical therapy program for Veterans with knee osteoarthritis. Allen, KD., Sheets, B., Bongiorni, D., et al.[2020]

A 12-month trial will compare two implementation support packages for a Group Physical Therapy Program aimed at treating knee osteoarthritis, with the goal of improving patient outcomes like pain and function while requiring fewer clinician hours.

This study is the first to assess the effectiveness of tailored, high-touch support versus standard low-touch support in implementing Group PT, which has shown promise in enhancing treatment delivery for knee OA patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Group physical therapy for knee osteoarthritis: protocol for a hybrid type III effectiveness-implementation trial. Webb, S., Drake, C., Coffman, CJ., et al.[2023]

A group exercise program for 40 subjects with knee osteoarthritis led to significant improvements in pain and physical function, with over 90% of scores showing positive changes after the program without increasing medication or fatigue.

Participants also experienced significant increases in gait velocity, cadence, and stride length, which were maintained two months after the program, indicating lasting benefits from the exercise intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A revised group exercise program for osteoarthritis of the knee. Fransen, M., Margiotta, E., Crosbie, J., et al.[2019]

In a randomized controlled trial of 237 patients with non-specific low back pain, both the group exercise programme (Back to Fitness) and individual physiotherapy showed no significant differences in improving disability scores at both three and twelve months.

Patients from materially deprived areas experienced less improvement in their back pain compared to those from more affluent areas, suggesting that socioeconomic factors may influence treatment outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized trial comparing a group exercise programme for back pain patients with individual physiotherapy in a severely deprived area. Carr, JL., Klaber Moffett, JA., Howarth, E., et al.[2016]

The enhanced transtheoretical model intervention (ETMI) significantly reduced back pain-related disability in patients with chronic low back pain compared to usual physical therapy, with a mean difference of 2.7 points on the Roland-Morris Disability Questionnaire after 12 months.

Patients receiving ETMI also reported better outcomes in pain intensity, physical activity, and physical health, while requiring fewer therapy sessions (3.5 for ETMI vs. 5.1 for controls), indicating a more efficient approach to treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Increasing Recreational Physical Activity in Patients With Chronic Low Back Pain: A Pragmatic Controlled Clinical Trial. Ben-Ami, N., Chodick, G., Mirovsky, Y., et al.[2017]

Group-based physiotherapy-led self-management interventions (GPSMI) for osteoarthritis (OA) and chronic low back pain (CLBP) are as effective as individual physiotherapy or standard medical management, based on a review of 22 studies.

Further research is needed to explore the best ways to measure the clinical effectiveness of GPSMI and to assess its cost-effectiveness in managing these common musculoskeletal conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effectiveness of physiotherapist-delivered group education and exercise interventions to promote self-management for people with osteoarthritis and chronic low back pain: a rapid review part I. Toomey, E., Currie-Murphy, L., Matthews, J., et al.[2022]

Physical therapy, whether delivered individually or in small groups, significantly improves pain, physical function, and health-related quality of life in patients with knee osteoarthritis, as shown in a study of 126 patients over 8 weeks.

Both treatment formats led to measurable improvements in knee strength and walking speed, with no significant differences in effectiveness between the two methods, indicating that either approach is beneficial for managing knee OA.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physical therapy is effective for patients with osteoarthritis of the knee: a randomized controlled clinical trial. Fransen, M., Crosbie, J., Edmonds, J.[2016]

Manual physical therapy and exercise have been shown to significantly improve function and reduce pain in patients with osteoarthritis, making them effective treatment options.

Various physical therapy methods, including thermal modalities, electrotherapy, therapeutic ultrasound, and balneotherapy, provide positive therapeutic effects and should be recommended as part of osteoarthritis treatment guidelines.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Physical therapy of osteoarthritis]. Kladny, B.[2018]

In a case series of seven patients with mild-to-moderate hip osteoarthritis, the addition of body weight supported treadmill training (BWSTT) to standard physical therapy resulted in significant reductions in pain (average NPRS improvement of 2.9 points) and disability (WOMAC improvement of 18.5 points).

Despite improvements in pain and function, the study found that these changes did not lead to significant short-term enhancements in gait endurance, as measured by the 6-minute walk test, which increased by an average of 60.5 meters.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The addition of body weight supported treadmill training to manual therapy and exercise in the management of Hip osteoarthritis: A case series. Garcia, WJ., Sorensen, M., Diana, LT., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Group physiotherapy provides similar outcomes for participants after joint replacement surgery as 1-to-1 physiotherapy: a sequential cohort study. [2009]

2. United States pubmed.ncbi.nlm.nih.gov

Guide to outcomes measurement for patients with low back pain syndromes. [2019]

3. England pubmed.ncbi.nlm.nih.gov

Implementation of a group physical therapy program for Veterans with knee osteoarthritis. [2020]

4. England pubmed.ncbi.nlm.nih.gov

Group physical therapy for knee osteoarthritis: protocol for a hybrid type III effectiveness-implementation trial. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

A revised group exercise program for osteoarthritis of the knee. [2019]

6. England pubmed.ncbi.nlm.nih.gov

A randomized trial comparing a group exercise programme for back pain patients with individual physiotherapy in a severely deprived area. [2016]

7. United States pubmed.ncbi.nlm.nih.gov

Increasing Recreational Physical Activity in Patients With Chronic Low Back Pain: A Pragmatic Controlled Clinical Trial. [2017]

8. Scotland pubmed.ncbi.nlm.nih.gov

The effectiveness of physiotherapist-delivered group education and exercise interventions to promote self-management for people with osteoarthritis and chronic low back pain: a rapid review part I. [2022]

9. Canada pubmed.ncbi.nlm.nih.gov

Physical therapy is effective for patients with osteoarthritis of the knee: a randomized controlled clinical trial. [2016]

10. Germany pubmed.ncbi.nlm.nih.gov

[Physical therapy of osteoarthritis]. [2018]

11. England pubmed.ncbi.nlm.nih.gov

The addition of body weight supported treadmill training to manual therapy and exercise in the management of Hip osteoarthritis: A case series. [2022]