Physical Therapy Program and Treatment Expectations in Knee Osteoarthritis

Официальное название

Evaluating The Predictive Effect of Treatment Expectations on Response to A Physical Therapy Program in Patients With Knee Osteoarthritis

Обзор

To our knowledge, no studies have been conducted in the literature investigating the relationship between the success of physical therapy programs applied in knee osteoarthritis and patients' pre-treatment expectations. The rationale for this study is to demonstrate the possible relationship between treatment expectations and the benefits seen from conventional physical therapy programs in patients with knee osteoarthritis, and to provide clinicians with a different perspective in knee osteoarthritis treatment planning.

Подробное описание

Osteoarthritis, also called degenerative joint disease, primarily occurs in old age, but can also develop after trauma or secondarily to diseases such as rheumatoid arthritis and hemochromatosis. Osteoarthritis is the most common joint disease worldwide. The pathophysiology of osteoarthritis is responsible for the failed repair of joint damage caused by stress initiated by any joint or periarticular tissue abnormality. The most common symptom of osteoarthritis is pain. Factors associated with an increased risk of knee osteoarthritis include advanced age, family history, overweight or obesity, a history of knee trauma, occupational factors, and varus or valgus alignment. Long-term complications of osteoarthritis include decreased physical activity, loss of fitness, sleep disturbances, fatigue, and depression. With the increasing aging population, degenerative joint problems have become a concern for a large part of society. Exercise is a key component in the treatment of this chronic disease, which restricts functionality and reduces quality of life. A systematic review of 54 randomized controlled trials involving a total of 5362 participants showed that different types of exercise improved pain, functionality, and quality of life in knee osteoarthritis. Studies have shown that treatment outcomes are not always similar in patients undergoing similar treatment programs, and that patients' expectations from treatment can also influence results. A systematic literature review on improvement expectations revealed that in 15 out of 16 studies, positive patient expectations were associated with better health outcomes. A recent study in the field of physical therapy also showed that in the treatment of chronic low back pain, high patient expectations were associated with the success of the treatment. Therefore, we planned this study to answer the questions of whether treatment expectations have a predictive effect on the benefits seen from an exercise program in patients with knee osteoarthritis, and whether it is necessary to evaluate the level of expectations when creating a treatment program for patients with knee osteoarthritis.

Вмешательства

• Другое Physical Therapy
  Patients in both groups will receive 15 sessions of a conventional physical therapy program.

Первичные конечные точки

• The Western Ontario and McMaster Universities Arthritis Index (WOMAC) score [Срок оценки: From enrollment day to the end of the rehabilitation program at 4 weeks]

Вторичные конечные точки (3)

• Pain level; VAS score [Срок оценки: From enrollment day to the end of the rehabilitation program at 4 weeks]
• Timed Up and Go Test (TUG) [Срок оценки: From enrollment day to the end of the rehabilitation program at 4 weeks]
• Stair Climbing Test (SCT) [Срок оценки: From enrollment day to the end of the rehabilitation program at 4 weeks]

Критерии участия

Критерии включения

• Agreeing to participate in the study
• Being over 50 years of age
• Having a clinically and radiographically confirmed diagnosis of knee osteoarthritis
• Having grade 2-3-4 knee osteoarthritis according to the Kellgren-Lawrence grading system
• Being literate

Критерии исключения

• Previous knee surgery
• Conditions that prevent exercise (such as incurable malignancy, active systemic infection, non-union fracture)
• Presence of accompanying neurological disease affecting the lower extremity
• Severe cognitive impairment (neuropsychiatric disease or condition that will impede cooperation, such as psychosis, dementia)
• History of having received injections or other procedures to the knee joint or physical therapy within the last 6 months

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Модель наблюдения

Когортное

Центры проведения

Turkey (Türkiye) · 1 центр

• Gazi University — Ankara

Публикации

• Fransen M, McConnell S, Harmer AR, Van der Esch M, Simic M, Bennell KL. Exercise for osteoarthritis of the knee: a Cochrane systematic review. Br J Sports Med. 2015 Dec;49(24):1554-7. doi: 10.1136/bjsports-2015-095424. Epub 2015 Sep 24. PMID 26405113
• Mondloch MV, Cole DC, Frank JW. Does how you do depend on how you think you'll do? A systematic review of the evidence for a relation between patients' recovery expectations and health outcomes. CMAJ. 2001 Jul 24;165(2):174-9. PMID 11501456
• Levenig CG, Hasenbring MI, Gunnewig L, Titze C, Elsenbruch S, Schulte TL. Treatment Expectations-You Get What You Expect-and Depression Plays a Role. J Pain. 2024 Sep;25(9):104582. doi: 10.1016/j.jpain.2024.104582. Epub 2024 May 29. PMID 38821312
• Myers SS, Phillips RS, Davis RB, Cherkin DC, Legedza A, Kaptchuk TJ, Hrbek A, Buring JE, Post D, Connelly MT, Eisenberg DM. Patient expectations as predictors of outcome in patients with acute low back pain. J Gen Intern Med. 2008 Feb;23(2):148-53. doi: 10.1007/s11606-007-0460-5. Epub 2007 Dec 8. PMID 18066631
• Robinson ME, Brown JL, George SZ, Edwards PS, Atchison JW, Hirsh AT, Waxenberg LB, Wittmer V, Fillingim RB. Multidimensional success criteria and expectations for treatment of chronic pain: the patient perspective. Pain Med. 2005 Sep-Oct;6(5):336-45. doi: 10.1111/j.1526-4637.2005.00059.x. PMID 16266354
• Abdel-Aziz MA, Ahmed HMS, El-Nekeety AA, Abdel-Wahhab MA. Osteoarthritis complications and the recent therapeutic approaches. Inflammopharmacology. 2021 Dec;29(6):1653-1667. doi: 10.1007/s10787-021-00888-7. Epub 2021 Nov 9. PMID 34755232
• Lespasio MJ, Piuzzi NS, Husni ME, Muschler GF, Guarino A, Mont MA. Knee Osteoarthritis: A Primer. Perm J. 2017;21:16-183. doi: 10.7812/TPP/16-183. PMID 29035179
• Jang S, Lee K, Ju JH. Recent Updates of Diagnosis, Pathophysiology, and Treatment on Osteoarthritis of the Knee. Int J Mol Sci. 2021 Mar 5;22(5):2619. doi: 10.3390/ijms22052619. PMID 33807695

Идентификаторы

NCT: NCT07618403 · Gonartroz -Tedavi Beklentisi

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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