Exercise therapy for knee osteoarthritis pain: 'How does it work?': KOA PAIN trial: Protocol for a randomized controlled trial

Research output: Unpublished contribution to conferencePoster

Abstract

Introduction
Previous research demonstrated that exercise-induced anti-inflammation and endogenous analgesia are most promising pathways to reduce knee-osteoarthritis pain (KOAP).
This study aims to investigate (1) the mediating role of inflammation and/or endogenous analgesia in the effect of exercise therapy (ET) (muscle strengthening training (MST); behavioral graded activity (BGA)) on KOAP and (2) whether KOAP changes are associated with acute treatment effects.
Methodology
A randomized-controlled trial will be conducted in UZ Brussel and AZ St-Dimpna Geel. KOAP patients(n=90) will be randomly assigned to the MST, BGA, or control group for a three-month intervention and twelve-month follow-up. MST involves leg muscle-strengthening exercises. BGA includes behavioral therapy combined with ET to gradually increase patients’ activity level. Control patients maintain their lifestyles.
The primary outcome is pain, evaluated by the Knee injury and Osteoarthritis Outcome Score. Secondary outcomes are pain subtypes, functionality in daily living, adherence/compliance, and medical consumption. Mediation analysis will be performed to evaluate the potential mediating role of (acute)inflammation and endogenous analgesia. The former will be tested by a blood-based biomarkerpanel for chronic-low-graded-inflammatory profile, the latter will be investigated by pain physiological tests. Assessments will be performed at baseline, at week 2-3 and week 10-11 (pre- and post-treatment for the acute effects),and 48h, 13 and 52 weeks after the last intervention.
Conclusion
This will be the first trial investigating (acute)inflammation and endogenous analgesia as potential mediators in the effect of ET on KOAP. By unravelling underlying mechanisms of ET in KOAP, treatment optimization can occur by tailoring ET towards acute effects.
Original languageEnglish
Publication statusPublished - 14 Feb 2020
EventBVGG - SBGG Wintermeeting -
Duration: 14 Feb 202015 Feb 2020

Conference

ConferenceBVGG - SBGG Wintermeeting
Period14/02/2015/02/20

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