The aim of Pain Neuroscience Education (PNE) is to explain to patients the biological and physiological processes involved in a pain experience and, more importantly, defocus the issues associated with the anatomical structures. PNE provides compelling evidence in reducing pain, disability, pain catastrophization, and limited physical movement in musculoskeletal problems. Knee osteoarthritis (KOA) is a very common painful musculoskeletal problem, especially in people over 50 years old, and lead to decrease in knee range of motion. Despite costly arthroscopic surgeries and long-term physiotherapy treatments, poor outcomes are common. The lack of satisfactory results suggests that some practices should be revised. Although PNE could be useful as an intervention, to our knowledge, there is no randomized controlled trial in the literature investigating the effects of PNE in patients with a KOA. Therefore, we aimed to examine the effectiveness of PNE on clinical outcomes in patients with KOA.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
34
The experimental group will follow a PNE protocol based on previous procedure for 6 weeks in addition to the standard physiotherapy program (SPP) in postoperative period. Each PNE session will take 45-60 min. PNE will be conducted in line with international guidelines and covered the neurophysiology of pain, transition from acute to chronic pain, and the nervous system ability to modulate the pain experience.
The control group will follow a SPP. The 45-minute-long treatment sessions will be held 5 days per week. The treatment program will be organized in 3 periods as 0-2 weeks, 3-4 weeks and 5-6 weeks. The overall treatment program will include scar massage, patellar mobilization, coldpack, ankle pump, quadriceps and hamstring strengthening, hip range of motion, hip strengthening exercises, squat, ascending and descending stairs, walking training. All exercises will be 10 repetitions x 2 sets.
Ahi Evran University
Kırşehir, Central, Turkey (Türkiye)
Pain severity
Visual Analogue Scale (0-10, higher means worse)
Time frame: Baseline
Pain severity change is being assessed
Visual Analogue Scale (0-10, higher means worse)
Time frame: 6 week
Pain and Function
Knee Injury and Osteoarthritis Outcome Score (0-100, higher means better)
Time frame: Baseline
Pain and Function change are being assessed
Knee Injury and Osteoarthritis Outcome Score (0-100, higher means better)
Time frame: 6 week
Pain and Function
Western Ontario and McMaster Universities Arthritis Index (0-96, higher means worse)
Time frame: Baseline
Pain and Function change are being assessed
Western Ontario and McMaster Universities Arthritis Index (0-96, higher means worse)
Time frame: 6 week
Pain Catastrophizing
Pain Catastrophizing Scale (0-52, higher means worse)
Time frame: Baseline
Pain Catastrophizing change is being assessed
Pain Catastrophizing Scale (0-52, higher means worse)
Time frame: 6 week
Kinesiophobia
Tampa Scale of Kinesiophobia (17-68, higher means worse)
Time frame: Baseline
Kinesiophobia change is being assessed
Tampa Scale of Kinesiophobia (17-68, higher means worse)
Time frame: 6 week
Level of quality of life
Short Form-12 (0-100, higher means better)
Time frame: Baseline
Level of quality of life change is being assessed
Short Form-12 (0-100, higher means better)
Time frame: 6 week
Anxiety and Depression
Hospital Anxiety Depression Scale (0-21, higher means worse)
Time frame: Baseline
Anxiety and Depression change is being assessed
Hospital Anxiety Depression Scale (0-21, higher means worse)
Time frame: 6 week
Physical Function
40 meter walking test (in seconds, less is better)
Time frame: Baseline
Physical Function change is being assessed
40 meter walking test (in seconds, less is better)
Time frame: 6 week
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