Association of Exercise Therapy and Reduction of Pain Sensitivity in Patients With Knee Osteoarthritis: A Randomized Controlled Trial

Exercise is effective for prevention and management of acute and chronic health conditions. However, trial descriptions of exercise interventions are often suboptimal, leaving readers unclear about the content of effective programmes. To address this, the 16-item internationally endorsed Consensus on Exercise Reporting Template (CERT) was developed. The aim is to present the final template and provide an Explanation and Elaboration Statement to operationalise the CERT. Development of the CERT was based on the EQUATOR Network methodological framework for developing reporting guidelines. We used a modified Delphi technique to gain consensus of international exercise experts and conducted 3 sequential rounds of anonymous online questionnaires and a Delphi workshop. The 16-item CERT is the minimum data set considered necessary to report exercise interventions. The contents may be included in online supplementary material, published as a protocol or located on websites and other electronic repositories. The Explanation and Elaboration Statement is intended to enhance the use, understanding and dissemination of the CERT and presents the meaning and rationale for each item, together with examples of good reporting. The CERT is designed specifically for the reporting of exercise programmes across all evaluative study designs for exercise research. The CERT can be used by authors to structure intervention reports, by reviewers and editors to assess completeness of exercise descriptions and by readers to facilitate the use of the published information. The CERT has the potential to increase clinical uptake of effective exercise programmes, enable research replication, reduce research waste and improve patient outcomes.

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“…Online supplementary appendices provided with comprehensive text descriptions and photographs or videos for each exercise26 44 45…”

Section: Resultsmentioning

confidence: 99%

Consensus on Exercise Reporting Template (CERT): Explanation and Elaboration Statement

et al. 2016

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“…Neuromuscular exercise was more effective for non-obese persons with a varus thrust; quadriceps strengthening was more effective for obese persons without a thrust (109). Pressure-pain sensitivity, temporal summation, and pain were reduced with exercise in patients with knee OA (110). Booster sessions with a physical therapist did not influence pain, function, or home exercise adherence in patients with knee OA (111).…”

Section: Resultsmentioning

confidence: 99%

Osteoarthritis year in review 2015: clinical

Sharma

2016

Osteoarthritis and Cartilage

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The purpose of this review is to highlight clinical research in osteoarthritis. A literature search was conducted using PubMed (http://www.ncbi.nlm.nih.gov/pubmed/) with the search terms “osteoarthritis [All Fields] AND treatment [All Fields]” and the following limits activated: humans, English language, all adult 19+ years, published between April 1, 2014 and April 1, 2015. A second literature search was then conducted with the search terms “osteoarthritis [All Fields] AND epidemiology [All Fields]”, with the same limits. Reports of surgical outcome, case series, surgical technique, tissue sample or culture studies, trial protocols, and pilot studies were excluded. Of 1523, 148 were considered relevant. Among epidemiologic and observational clinical studies, themes included physical activity, early knee OA, and confidence/instability/falls. Symptom outcomes of pharmacologic treatments were reported for methotrexate, adalimumab, anti-nerve growth factor monoclonal antibodies, strontium ranelate, bisphosphonates, glucosamine, and chondroitin sulfate, and structural outcomes of pharmacologic treatments for strontium ranelate, recombinant human fibroblast growth factor 18, and glucosamine and chondroitin sulfate. Symptom outcomes of non-pharmacologic interventions were reported for: neuromuscular exercise, quadriceps strengthening, weight reduction and maintenance, TENS, therapeutic ultrasound, stepped care strategies, cognitive behavior therapy for sleep disturbance, acupuncture, gait modification, booster physical therapy, a web-based therapeutic exercise resource center for knee OA; hip physical therapy for hip OA; and joint protection and hand exercises for hand OA. Structure outcomes of non-pharmacologic interventions were reported for patellofemoral bracing.

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“…The sample size was based on the primary outcome,10 and accounting for possible dropouts the sample was 60 participants.…”

Section: Methodsmentioning

confidence: 99%

“…The primary outcome is reported elsewhere. 10 Participants were recruited through March-December 2012 from the OA outpatient clinic of Copenhagen University Hospital at Frederiksberg, Copenhagen, Denmark. Eligible participants were adults aged 40 years or over with a clinical diagnosis of knee OA confirmed by radiography, and a body mass index between 20 kg/m 2 and 35 kg/m 2 .…”

Section: Methodsmentioning

confidence: 99%

No effects of functional exercise therapy on walking biomechanics in patients with knee osteoarthritis: exploratory outcome analyses from a randomised trial

Henriksen

Klokker

Bartholdy

et al. 2017

BMJ Open Sport Exerc Med

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AimTo assess the effects of a functional and individualised exercise programme on gait biomechanics during walking in people with knee OA.MethodsSixty participants were randomised to 12 weeks of facility-based functional and individualised neuromuscular exercise therapy (ET), 3 sessions per week supervised by trained physical therapists, or a no attention control group (CG). Three-dimensional gait analyses were used, from which a comprehensive list of conventional gait variables were extracted (totally 52 kinematic, kinetic and spatiotemporal variables). According to the protocol, the analyses were based on the ‘Per-Protocol’ population (defined as participants following the protocol with complete and valid gait analyses). Analysis of covariance adjusting for the level at baseline was used to determine differences between groups (95% CIs) in the changes from baseline at follow-up.ResultsThe per-protocol population included 46 participants (24 ET/22 CG). There were no group differences in the analysed gait variables, except for a significant group difference in the second peak knee flexor moment and second peak vertical ground reaction force.ConclusionWhile plausible we have limited confidence in the findings due to multiple statistical tests and lack of biomechanical logics. Therefore we conclude that a 12-week supervised individualised neuromuscular exercise programme has no effects on gait biomechanics. Future studies should focus on exercise programmes specifically designed to alter gait patterns, or include other measures of mobility, such as walking on stairs or inclined surfaces.Trial registration numberClinicalTrials.gov: NCT01545258.

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Association of Exercise Therapy and Reduction of Pain Sensitivity in Patients With Knee Osteoarthritis: A Randomized Controlled Trial

Cited by 102 publications

References 34 publications

Consensus on Exercise Reporting Template (CERT): Explanation and Elaboration Statement

Consensus on Exercise Reporting Template (CERT): Explanation and Elaboration Statement

Osteoarthritis year in review 2015: clinical

No effects of functional exercise therapy on walking biomechanics in patients with knee osteoarthritis: exploratory outcome analyses from a randomised trial

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