Pain Informed Movement for Knee Osteoarthritis

Recruiting in Palo Alto (17 mi)

Overseen byLisa Carlesso, PhD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: McMaster University

No Placebo Group

Trial Summary

What is the purpose of this trial?The goal of this clinical trial is to compare a pain informed movement program to standard neuromuscular exercise in people with knee osteoarthritis. The main question it aims to answer are: 1. Are the two interventions a) pain informed movement program plus pain neuroscience education and b) neuromuscular exercise plus standard osteoarthritis education feasible in terms of recruitment, treatment adherence, timelines, data collection procedures, patient follow-up, and resources required? 2. Is there a difference in patient's satisfaction and acceptability of the two programs? 3. Are there any differences in the potential effects of the two programs on subjective pain measures, self-reported function, quality of life, functional leg strength, nervous system pain modulation, brain derived neurotrophic factor and nerve growth factor levels, and psychological factors?

Eligibility Criteria

This trial is for people over 40 with knee osteoarthritis who've had regular pain in the past month. They must speak English, have internet access, and be able to move without help. It's not for those with recent knee trauma/surgery, injections in the knee within 3 months, or involved in other OA trials.

Inclusion Criteria

≥40 years of age with diagnosis of knee osteoarthritis (OA) by a physician

You experience mild to moderate pain most days, with an average intensity of 3 out of 10 on a pain scale.

You are at least 45 years old and have knee pain that gets worse with activity, even if it's just in the morning and lasts for about 30 minutes.

Exclusion Criteria

Cannot communicate in English

Have had any injection in the index knee within 3-months prior to baseline assessment

Does not have regular access to the internet

+9 more

Participant Groups

The study compares a pain informed movement program plus Pain Neuroscience Education (PNE) against standard neuromuscular exercises with basic OA education. It checks which is more feasible and satisfactory for patients and measures effects on pain, function, quality of life, strength, nerve factors.

2Treatment groups

Experimental Treatment

Active Control

Group I: Pain Informed Movement and pain neuroscience educationExperimental Treatment2 Interventions

Participants will receive a twice weekly, 8 week in-person group exercise program, consisting of exercise instruction (75 minutes) and pain neuroscience education (PNE) videos (20 to 30 minutes/week for the first 4 weeks). During the exercise sessions, the educational components and concepts such as mindfulness, muscle tension regulation, and breathing techniques will be applied by the instructor. A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component will be delivered by an experienced yoga teacher that has been extensively trained. The PNE video component will cover the following topics: The purpose of pain, neurophysiological changes of pain, movement guidelines when pain persists, and self-care techniques to impact neurophysiology and support moving with ease that include breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness.

Group II: Standard neuromuscular exercise and OA educationActive Control2 Interventions

Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.