Exercise for Chronic Knee Pain
Recruiting in Palo Alto (17 mi)
Overseen byKosaku Aoyagi, PhD
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of Texas, El Paso
Must not be taking: Opioids
Disqualifiers: Peripheral neuropathy, Pregnancy, Cognitive impairment, others
No Placebo Group
Approved in 1 Jurisdiction
Trial Summary
What is the purpose of this trial?The objective of the study is to explore the effects of arm exercise (UE, arm ergometer) vs. leg exercise (LE, cycling ergometer) on exercise-induced hypoalgesia (EIH), central pain mechanisms and knee pain in people with knee osteoarthritis (OA). Furthermore, we will explore relations of socioeconomic status, racial discrimination, acculturative stress, and autonomic function to exercise effects on EIH, central pain mechanisms, and knee pain. This will be a pilot randomized cross-over study where all participants undergo Day 1 (baseline assessments), Day 2 (UE or LE), and Day 3 (UE or LE).
Will I have to stop taking my current medications?
The trial does not specify if you need to stop taking your current medications, but it excludes those who use opioids regularly. It's best to discuss your specific medications with the trial coordinators.
What data supports the effectiveness of the treatment Exercise, Physical Activity, Workout, Fitness Training for chronic knee pain?
Research shows that exercise and physical activity can improve pain and function in people with knee osteoarthritis, a common cause of chronic knee pain. High-intensity exercise may offer greater health benefits, and task-specific training has been shown to improve pain and function in individuals with chronic knee pain.
12345Is exercise safe for people with chronic knee pain?
Exercise is generally safe for people with chronic knee pain and can help reduce pain and improve function. Unlike some pain medications, exercise does not have harmful side effects and can improve muscle strength and overall health.
36789How is exercise different from other treatments for chronic knee pain?
Exercise is a non-drug treatment that helps reduce pain and improve function in knee osteoarthritis by strengthening muscles, improving joint movement, and increasing physical activity levels. Unlike medications, it doesn't have side effects and can be tailored to individual needs, including weight loss and addressing other health conditions.
36101112Eligibility Criteria
This trial is for people over 45 with knee osteoarthritis and a pain level of at least 4 out of 10. They must understand English, have activity-related knee pain, and not have morning stiffness lasting over half an hour. Excluded are those with pacemakers, pregnant women, severe diseases, past knee replacements, sensation loss where pain is measured, chronic opioid use or certain arthritis types.Inclusion Criteria
My main pain issue is in my knee.
My knee pain is at least a 4 out of 10.
I am 45 years old or older.
+4 more
Exclusion Criteria
I have numbness or loss of feeling in areas like my wrist, knee, or forearm.
You have been taking opioids for a long time.
I cannot exercise because of severe pain or symptoms.
+7 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
1-2 weeks
Baseline Assessment
Day 1: Collection of participant characteristics, race/ethnicity data, and baseline pain assessments
1 day
1 visit (in-person)
Treatment
Day 2 and Day 3: Participants undergo either upper extremity or lower extremity exercise with pain assessments before and after exercise
2 days (separated by at least 1 week)
2 visits (in-person)
Follow-up
Participants are monitored for safety and effectiveness after treatment
4 weeks
Participant Groups
The study tests how arm exercises using an arm ergometer versus leg exercises on a cycling ergometer affect pain relief after exercise in individuals with knee osteoarthritis. It also examines the impact of socioeconomic factors and stress on this exercise-induced hypoalgesia through a pilot randomized cross-over design.
2Treatment groups
Experimental Treatment
Active Control
Group I: ExerciseExperimental Treatment1 Intervention
Arm 1: All participants, knee OA and pain-free individuals, will undergo a single exercise of arm exercise using an arm ergometer and;
Group II: Lower Body ExerciseActive Control1 Intervention
Arm 2: All participants, knee OA and pain-free individuals, will undergo a single exercise of leg exercise using a cycling ergometer.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
The University of Texas at El PasoEl Paso, TX
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Who Is Running the Clinical Trial?
University of Texas, El PasoLead Sponsor
References
Task-Specific Training for Adults With Chronic Knee Pain: A Case Series. [2022]Study Design Case series. Background Recent evidence suggests that traditional impairment-based rehabilitation approaches for patients with knee pain may not result in improved function or reduced disability. This case series describes a novel task-specific training approach to exercise therapy for patients with chronic knee pain and reports changes in measures of clinical outcome (pain and physical function) following participation in the training program. Case Description Seven patients with chronic knee pain aged 40 years or older were included. Each reported at least "moderate" difficulty with sit-to-stand transfers, floor transfers, and/or stair negotiation at baseline. Experienced physical therapists provided between 8 and 16 treatment sessions focusing on improving performance of difficult or painful tasks. Outcomes A majority of patients demonstrated clinically important improvements in both patient-rated outcomes (Knee injury and Osteoarthritis Outcome Score, numeric pain-rating scale, modified Arthritis Self-Efficacy Scale) and performance-based outcomes (30-second chair-rise test, timed stair-climb test, floor transfer test, Performance Assessment of Self-Care Skills). Discussion A task-specific training approach for patients with chronic knee pain was described and yielded considerable improvement in pain and function for most of the individuals in this case series. Larger studies are needed to determine how task-specific training compares with more traditional impairment-based exercise approaches for chronic knee pain. Level of Evidence Therapy, level 5. J Orthop Sports Phys Ther 2017;47(8):548-556. doi:10.2519/jospt.2017.7349.
High-intensity versus low-intensity physical activity or exercise in people with hip or knee osteoarthritis. [2022]Exercise or physical activity is recommended for improving pain and functional status in people with knee or hip osteoarthritis. These are complex interventions whose effectiveness depends on one or more components that are often poorly identified. It has been suggested that health benefits may be greater with high-intensity rather than low-intensity exercise or physical activity.
Change in physical activity level and clinical outcomes in older adults with knee pain: a secondary analysis from a randomised controlled trial. [2022]Exercise interventions improve clinical outcomes of pain and function in adults with knee pain due to osteoarthritis and higher levels of physical activity are associated with lower severity of pain and higher levels of physical functioning in older adults with knee osteoarthritis in cross-sectional studies. However, to date no studies have investigated if change in physical activity level during exercise interventions can explain clinical outcomes of pain and function. This study aimed to investigate if change in physical activity during exercise interventions is associated with future pain and physical function in older adults with knee pain.
The impact of physical activity level on the short- and long-term pain relief from supervised exercise therapy and education: a study of 12,796 Danish patients with knee osteoarthritis. [2019]It is unknown if people with knee osteoarthritis (OA) who are already physically active benefit from exercise therapy. To study the impact of physical activity level on pain relief, post-intervention and 12 months following exercise therapy and education.
Factors associated with pain resolution in those with knee pain: the MOST study. [2023]To determine how many persons with knee pain have subsequent pain resolution and what factors are associated with resolution, focusing especially on types of physical activity.
[Exercise therapy in hip or knee osteoarthritis]. [2011]"Exercise is medicine": exercise therapy reduces pain and activity limitations in osteoarthritis of the knee and is likely to have the same effects in osteoarthritis of the hip. Further research into exercise therapy is needed, since disease-modifying drugs are not available, pain medication can cause side effects, and surgical interventions are preferably applied in an advanced stage of disease. Classical exercise therapy is aimed at improving muscle strength, aerobic capacity, range of joint motion, and training of walking and activities of daily living. New modalities of targeted exercise therapy are currently being developed, aimed at the correction of low levels of activity and to correct instability of the knee. Weight loss, preferably combined with exercise therapy, reduces pain and activity limitations in osteoarthritis patients who are overweight. Modalities of exercise therapy adapted to comorbid conditions are currently being developed.
The relationship between experience of knee pain and physical activity participation: A scoping review of quantitative studies. [2023]Physical activity (PA) in people with knee pain can help to relieve pain and prevent health problems. However, engaging in regular PA is challenging for them due to chronic musculoskeletal pain. An understanding of how the experience of knee pain affects PA is important to minimize the negative effects of knee pain on participation in PA among this population. We examined the quantitative evidence describing the relationship between the experience of knee pain and participation in PA.
Impairment-targeted exercises for older adults with knee pain: protocol for a proof-of-principle study. [2021]Exercise therapy for knee pain and osteoarthritis remains a key element of conservative treatment, recommended in clinical guidelines. Yet systematic reviews point to only modest benefits from exercise interventions.One reason for this might be that clinical trials tend to use a one-size-fits-all approach to exercise, effectively disregarding the details of their participants' clinical presentations. This uncontrolled before-after study (TargET-Knee-Pain) aims to test the principle that exercises targeted at the specific physical impairments of older adults with knee pain may be able to significantly improve those impairments. It is a first step towards testing the effectiveness of this more individually-tailored approach.
Effectiveness and safety of strengthening, aerobic, and coordination exercises for patients with osteoarthritis. [2022]Exercise has generated interest as an important nonpharmacological treatment for symptomatic osteoarthritis (OA) of the hip and knee. Effect sizes in exercise interventions are small to moderate for pain and functional improvements and are similar to those observed for improvement in pain for nonsteroidal anti-inflammatory drugs (NSAIDS). However, in contrast to NSAIDS, exercise interventions are safe and improve function through a direct effect on muscle strength and function. Both aerobic and strengthening exercises seem to be equally effective in regard to pain and function in patients with OA. In obese patients with OA, a combination of diet and exercise may be advantageous for optimal benefits in health-related quality-of-life and physical function. This article will focus on recent (September 2001-August 2002) randomized controlled trials with exercise as an intervention in patients with OA.
Dose-Response Effects of Tai Chi and Physical Therapy Exercise Interventions in Symptomatic Knee Osteoarthritis. [2019]Therapeutic exercise is a currently recommended nonpharmacological treatment for knee osteoarthritis (KOA). The optimal treatment dose (frequency or duration) has not been determined.
Evidence synthesis of types and intensity of therapeutic land-based exercises to reduce pain in individuals with knee osteoarthritis. [2020]The objective of this study is to construct an evidence synthesis to identify the types of land-based exercises most investigated in the current literature, the intervention duration, frequency of the programs and the exercises which are most frequently implemented. A search was performed on the reference list of included and excluded studies of one systematic review, on land-based exercises for knee osteoarthritis and, an updated search of The Cochrane Library, Embase, CINAHL and PEDro was completed. Two authors independently selected the studies and a third author was consulted for an additional opinion. The inclusion criteria were male or female with tibiofemoral knee osteoarthritis, land-based exercises, non-exercise control group and randomized clinical trials. The exclusion criteria were mixed diagnosis or comparison to other types of exercise. The data were extracted by two authors. Fifty-five full-text articles were included. Strengthening, proprioception and aerobic exercises resulted in significant pain reduction. The intervention durations which were significant for pain reduction were either the period of 8-11 weeks or 12-15 weeks. The frequency of three times per week was found significant in comparison to a non-exercise control group. The results, which formed an evidence synthesis, demonstrate that there is substantial evidence regarding the benefits of strengthening exercises to reduce pain in knee osteoarthritis patients. Based on the included studies analysis, exercises should be performed three times weekly for a duration of 8-11 or 12-15 weeks. Health professionals working with knee osteoarthritis patients can use this evidence synthesis as a fast and pragmatic instrument to obtain information about several effective types of exercises for pain reduction.
Exercise Therapy for Knee Osteoarthritis: A Systematic Review and Network Meta-analysis. [2023]Exercise is an effective nonpharmaceutical therapy for knee osteoarthritis (KOA).