Eeva-Eerika Helminen1, Sanna H Sinikallio2, Anna L Valjakka3, Rauni H Väisänen-Rouvali4, Jari P A Arokoski5. 1. Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Kuopio, Finland Psychiatry, City of Helsinki Health Centre, Helsinki, Finland eeva-eerika.helminen@fimnet.fi. 2. Institution of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland. 3. Department of Psychiatry, Addiction Psychiatry Outpatient Clinic, Kuopio University Hospital, Kuopio, Finland. 4. Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Kuopio, Finland. 5. Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Kuopio, Finland Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
Abstract
OBJECTIVE: To assess the effectiveness of a six week cognitive-behavioural group intervention in patients with knee osteoarthritis pain. DESIGN: Single-blinded randomized controlled trial. STUDY SETTING:Primary care providers in a medium-sized city in Finland. PATIENTS: A total of 111 participants aged from 35 to 75 with clinical symptoms and radiographic grading (Kellgren-Lawrence 2-4) of knee osteoarthritis were included. INTERVENTIONS: In the intervention group, 55 participants attended acognitive-behavioural training programme for pain management with six weekly group sessions supervised by a psychologist and a physiotherapist. Concurrently, they and the 56 participants of the control group continued in ordinary GP care that was not altered by the study. MAIN MEASURES: The primary outcome on three-month and 12-month follow-up was the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis index pain subscale. Secondary outcome measures included self-reports of pain and physical function, health-related quality of life, and a comprehensive set of psychological questionnaires. RESULTS: Mixed model results showed no significant differences between the intervention and control group for any measures of pain or function. A significant difference between the groups was found in the Pain Self-Efficacy Questionnaire (Pr = 0.022) in favour of the control group, and in the RAND-36 emotional well-being subscale in favour of the intervention group (Pr = 0.038). Conventional group comparisons of mean follow-up values showed no significant differences in any of the outcome variables. CONCLUSION: This trial could not confirm the hypothesized advantage of a cognitive-behavioural training programme over ordinary GP care in knee osteoarthritis pain patients. TRIAL REGISTRATION: Current Controlled Trials ISRCTN64794760.
RCT Entities:
OBJECTIVE: To assess the effectiveness of a six week cognitive-behavioural group intervention in patients with knee osteoarthritis pain. DESIGN: Single-blinded randomized controlled trial. STUDY SETTING: Primary care providers in a medium-sized city in Finland. PATIENTS: A total of 111 participants aged from 35 to 75 with clinical symptoms and radiographic grading (Kellgren-Lawrence 2-4) of knee osteoarthritis were included. INTERVENTIONS: In the intervention group, 55 participants attended a cognitive-behavioural training programme for pain management with six weekly group sessions supervised by a psychologist and a physiotherapist. Concurrently, they and the 56 participants of the control group continued in ordinary GP care that was not altered by the study. MAIN MEASURES: The primary outcome on three-month and 12-month follow-up was the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis index pain subscale. Secondary outcome measures included self-reports of pain and physical function, health-related quality of life, and a comprehensive set of psychological questionnaires. RESULTS: Mixed model results showed no significant differences between the intervention and control group for any measures of pain or function. A significant difference between the groups was found in the Pain Self-Efficacy Questionnaire (Pr = 0.022) in favour of the control group, and in the RAND-36 emotional well-being subscale in favour of the intervention group (Pr = 0.038). Conventional group comparisons of mean follow-up values showed no significant differences in any of the outcome variables. CONCLUSION: This trial could not confirm the hypothesized advantage of a cognitive-behavioural training programme over ordinary GP care in knee osteoarthritis painpatients. TRIAL REGISTRATION: Current Controlled Trials ISRCTN64794760.
Authors: Eeva-Eerika Helminen; Sanna H Sinikallio; Anna L Valjakka; Rauni H Väisänen-Rouvali; Jari Pa Arokoski Journal: Clin Rehabil Date: 2016-09 Impact factor: 3.477