Abstract
This assessor-, therapist-, and participant-blinded randomised controlled trial evaluated the effects of an automated internet-based pain coping skills training (PCST) program before home exercise for people with clinically diagnosed hip osteoarthritis.One hundred forty-four people were randomised to either the PCST group or the comparator group. In the first 8 weeks, the PCST group received online education and PCST, whereas the comparison group received online education only. From weeks 8 to 24, both groups visited a physiotherapist 5 times for home exercise prescription. Assessments were performed at baseline, 8, 24, and 52 weeks. Primary outcomes were hip pain on walking (11-point numerical rating scale) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]) at 24 weeks. Secondary outcomes were other measures of pain, quality-of-life, global change, selfefficacy, pain coping, pain catastrophizing, depression, anxiety, stress, physical activity, and adverse events. Primary outcomes were completed by 137 (95%), 131 (91%), and 127 (88%) participants at 8, 24, and 52weeks, respectively. Therewere no significant betweengroup differences in primary outcomes at week 24 (change in: walking pain [mean difference 0.5 units; 95% confidence interval,20.3 to 1.3] and function [20.9 units; 95%confidence interval,24.8 to 2.9]),with both groups showing clinically relevant improvements. Atweek 8, the PCST group had greater improvements in function, pain coping, and global improvement than comparison. Greater pain coping improvements persisted at 24 and 52 weeks. In summary, online PCST immediately improved pain coping and function but did not confer additional benefits to a subsequent exercise program, despite sustained pain coping improvements.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1833-1842 |
| Number of pages | 10 |
| Journal | Pain |
| Volume | 159 |
| Issue number | 9 |
| DOIs | |
| State | Published - Sep 2018 |
Funding
All authors have completed the ICMJE uniform disclosure and declare support for the submitted work; K.L. Bennell reports grants from the National Health and Medical Research Council during the conduct of the study; personal fees from Physitrack, ASICS Oceania, Peking University, and Brigham and Women’s Hospital outside the submitted work; and other support from ASICS Oceania outside the submitted work. R.K. Nelligan reports grants from the National Health and Medical Research Council during the conduct of the study. F.D. reports grants from the National Health and Medical Research Council during the conduct of the study and personal fees from Elsevier Oracle outside the submitted work. P.W. Hodges reports grants from the National Health and Medical Research Council during the conduct of the study. R.S. Hinman reports grants from the National Health and Medical Research Council and Australian Research Council Future Fellowship during the conduct of the study; a grant from Medibank Better Health Foundation and other support from ASICS Oceania outside the submitted work. The remaining authors have no conflicts of interests to disclose. This trial was funded by the National Health and Medical Research Council Program grant (#631717). The funders had no role in the study other than to provide funding. The PCST program was codeveloped by 2 of the investigators (F.J.K. and C.R.) with funding from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, part of the United States National Institutes of Health (award no. R01 AR057346).
Keywords
- Exercise
- Hip
- Osteoarthritis
- Pain coping skills training
- Physical therapy
ASJC Scopus subject areas
- Neurology
- Clinical Neurology
- Anesthesiology and Pain Medicine