Exercise Therapy for Knee Osteoarthritis Pain: How Does It Work? A Study Protocol for a Randomised Controlled Trial

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aut.relation.issue1
aut.relation.journalBMJ open
aut.relation.startpagee074258
aut.relation.volume14
dc.contributor.authorBeckwée, D
dc.contributor.authorNijs, J
dc.contributor.authorBierma-Zeinstra, SMA
dc.contributor.authorLeemans, L
dc.contributor.authorLeysen, L
dc.contributor.authorPuts, S
dc.contributor.authorRice, D
dc.contributor.authorSchiphof, D
dc.contributor.authorBautmans, I
dc.date.accessioned2024-01-31T01:10:35Z
dc.date.available2024-01-31T01:10:35Z
dc.date.issued2024-01-10
dc.description.abstractINTRODUCTION: Muscle strengthening training (MST) and behavioural graded activity (BGA) show comparable effects on knee osteoarthritic (KOA) pain, but the mechanisms of action remain unclear. Both exercise-induced anti-inflammation and central sensitisation are promising pathways for pain relief in response to exercise therapy in patients with KOA: MST has the potential to decrease inflammation and BGA has the potential to decrease central sensitisation. Hence, this study aims to examine inflammation and central sensitisation as mediators for the effect of MST and/or BGA on pain in patients with KOA. METHODS AND ANALYSIS: The Knee OsteoArthritis PAIN trial started on 10 January 2020 (anticipated end: April 2024). The three-arm clinical trial aims to recruit 90 KOA patients who will be randomly allocated to 12 weeks of (1) MST, (2) BGA or (3) care as usual. Assessments will be performed at baseline, 13 and 52 weeks after finishing the intervention. Outcomes, including pain (Knee injury and Osteoarthritis Outcome Score), were chosen in line with the OARSI recommendations for clinical trials of rehabilitation interventions for OA and the IMMPACT/OMERACT recommendations for the assessment of physical function in chronic pain clinical trials. Inflammation as well as features of central sensitisation (including conditioned pain modulation, offset analgesia, temporal summation of pain and event-related potentials following electrical stimulation), will be considered as treatment mediators. A multiple mediators model will be estimated with a path-analysis using structural equation models. In July 2023, all 90 KOA patients have been included and 42 participants already finished the study. ETHICS AND DISSEMINATION: This study obtained ethics approval (B.U.N. 143201941843). Unravelling the mechanisms of action of exercise therapy in KOA will not only be extremely valuable for researchers, but also for exercise immunology and pain scientists and clinicians. TRIAL REGISTRATION NUMBER: NCT04362618.
dc.identifier.citationBMJ open, ISSN: 2044-6055 (Print); 2044-6055 (Online), BMJ, 14(1), e074258-. doi: 10.1136/bmjopen-2023-074258
dc.identifier.doi10.1136/bmjopen-2023-074258
dc.identifier.issn2044-6055
dc.identifier.issn2044-6055
dc.identifier.urihttp://hdl.handle.net/10292/17168
dc.languageeng
dc.publisherBMJ
dc.relation.urihttps://bmjopen.bmj.com/content/14/1/e074258
dc.rights© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions.
dc.rights.accessrightsOpenAccess
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectChronic Pain
dc.subjectMusculoskeletal disorders
dc.subjectREHABILITATION MEDICINE
dc.subject4201 Allied Health and Rehabilitation Science
dc.subject32 Biomedical and Clinical Sciences
dc.subject3202 Clinical Sciences
dc.subject42 Health Sciences
dc.subjectChronic Pain
dc.subjectPain Research
dc.subjectRehabilitation
dc.subjectClinical Trials and Supportive Activities
dc.subjectClinical Research
dc.subjectArthritis
dc.subject6 Evaluation of treatments and therapeutic interventions
dc.subject6.1 Pharmaceuticals
dc.subjectMusculoskeletal
dc.subject1103 Clinical Sciences
dc.subject1117 Public Health and Health Services
dc.subject1199 Other Medical and Health Sciences
dc.subject32 Biomedical and clinical sciences
dc.subject42 Health sciences
dc.subject52 Psychology
dc.subject.meshHumans
dc.subject.meshOsteoarthritis, Knee
dc.subject.meshExercise Therapy
dc.subject.meshInflammation
dc.subject.meshChronic Pain
dc.subject.meshPain Management
dc.subject.meshRandomized Controlled Trials as Topic
dc.subject.meshHumans
dc.subject.meshOsteoarthritis, Knee
dc.subject.meshExercise Therapy
dc.subject.meshInflammation
dc.subject.meshChronic Pain
dc.subject.meshPain Management
dc.subject.meshRandomized Controlled Trials as Topic
dc.titleExercise Therapy for Knee Osteoarthritis Pain: How Does It Work? A Study Protocol for a Randomised Controlled Trial
dc.typeJournal Article
pubs.elements-id535239
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