Kim L Bennell1, Christine Rini2, Francis Keefe3, Simon French4, Rachel Nelligan5, Jessica Kasza6, Andrew Forbes7, Fiona Dobson8, J Haxby Abbott9, Andrew Dalwood10, Bill Vicenzino11, Anthony Harris12, Rana S Hinman13. 1. K.L. Bennell, PhD, Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Alan Gilbert Building, 161 Barry St, Carlton, Victoria 3053, Australia. k.bennell@unimelb.edu.au. 2. C. Rini, PhD, Thurston Arthritis Research Center and Gillings School of Global Public Health, Department of Health Behavior, University of North Carolina at Chapel Hill, Raleigh, North Carolina. 3. F. Keefe, PhD, Pain Prevention and Treatment Research Program, Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina. 4. S. French, PhD, Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, and School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada. 5. R. Nelligan, BPhysio, Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne. 6. J. Kasza, PhD, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. 7. A. Forbes, PhD, Department of Epidemiology and Preventive Medicine, Monash University. 8. F. Dobson, PhD, Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne. 9. J. Haxby Abbott, PhD, Centre for Musculoskeletal Outcomes Research, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. 10. A. Dalwood, BSc(Physio), GradDip(ManipTherapy), Physioworks Health Group, Camberwell, Victoria, Australia. 11. B. Vicenzino, PhD, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia. 12. A. Harris, MSc, Centre for Health Economics, Monash University. 13. R.S. Hinman, PhD, Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne.
Abstract
BACKGROUND: Persistent hip pain in older people is usually due to hip osteoarthritis (OA), a major cause of pain, disability, and psychological dysfunction. OBJECTIVE: The purpose of this study is to evaluate whether adding an Internet-based pain coping skills training (PCST) protocol to a standardized intervention of education followed by physical therapist-instructed home exercise leads to greater reductions in pain and improvements in function. DESIGN: An assessor-, therapist-, and participant-blinded randomized controlled trial will be conducted. SETTING: The study will be conducted in a community setting. PARTICIPANTS: The participants will be 142 people over 50 years of age with self-reported hip pain consistent with hip OA. INTERVENTION: Participants will be randomly allocated to: (1) a control group receiving a 24-week standardized intervention comprising an 8-week Internet-based education package followed by 5 individual physical therapy exercise sessions plus home exercises (3 times weekly) or (2) a PCST group receiving an 8-week Internet-based PCST protocol in addition to the control intervention. MEASUREMENTS: Outcomes will be measured at baseline and 8, 24, and 52 weeks, with the primary time point at 24 weeks. Primary outcomes are hip pain on walking and self-reported physical function. Secondary outcomes include health-related quality-of-life, participant-perceived treatment response, self-efficacy for pain management and function, pain coping attempts, pain catastrophizing, and physical activity. Measurements of adherence, adverse events, use of health services, and process measures will be collected at 24 and 52 weeks. Cost-effectiveness will be assessed at 52 weeks. LIMITATIONS: A self-reported diagnosis of persistent hip pain will be used. CONCLUSIONS: The findings will help determine whether adding an Internet-based PCST protocol to standardized education and physical therapist-instructed home exercise is more effective than education and exercise alone for persistent hip pain. This study has the potential to guide clinical practice toward innovative modes of psychosocial health care provision.
RCT Entities:
BACKGROUND: Persistent hip pain in older people is usually due to hip osteoarthritis (OA), a major cause of pain, disability, and psychological dysfunction. OBJECTIVE: The purpose of this study is to evaluate whether adding an Internet-based pain coping skills training (PCST) protocol to a standardized intervention of education followed by physical therapist-instructed home exercise leads to greater reductions in pain and improvements in function. DESIGN: An assessor-, therapist-, and participant-blinded randomized controlled trial will be conducted. SETTING: The study will be conducted in a community setting. PARTICIPANTS: The participants will be 142 people over 50 years of age with self-reported hip pain consistent with hip OA. INTERVENTION: Participants will be randomly allocated to: (1) a control group receiving a 24-week standardized intervention comprising an 8-week Internet-based education package followed by 5 individual physical therapy exercise sessions plus home exercises (3 times weekly) or (2) a PCST group receiving an 8-week Internet-based PCST protocol in addition to the control intervention. MEASUREMENTS: Outcomes will be measured at baseline and 8, 24, and 52 weeks, with the primary time point at 24 weeks. Primary outcomes are hip pain on walking and self-reported physical function. Secondary outcomes include health-related quality-of-life, participant-perceived treatment response, self-efficacy for pain management and function, pain coping attempts, pain catastrophizing, and physical activity. Measurements of adherence, adverse events, use of health services, and process measures will be collected at 24 and 52 weeks. Cost-effectiveness will be assessed at 52 weeks. LIMITATIONS: A self-reported diagnosis of persistent hip pain will be used. CONCLUSIONS: The findings will help determine whether adding an Internet-based PCST protocol to standardized education and physical therapist-instructed home exercise is more effective than education and exercise alone for persistent hip pain. This study has the potential to guide clinical practice toward innovative modes of psychosocial health care provision.
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