The KOMPACT-P study: Knee Osteoarthritis Management with Physiotherapy informed by Acceptance and Commitment Therapy—Pilot study protocol

Abstract

IntroductionIncidence of total knee arthroplasty (TKA) is projected to rise 276% in 2030, and psychological distress affects up to 42% of people with knee osteoarthritis undergoing TKA, with demonstrated detrimental effects on postoperative outcomes. Few studies have assessed psychological treatment in people awaiting TKA, and these have been psychologist-delivered treatments. No evidence exists regarding psychologically-informed interventions delivered by health professionals currently embedded in TKA clinical pathways. The primary aim of this pilot study is to explore the safety, acceptability and feasibility of the Knee Osteoarthritis Management with Physiotherapy informed by Acceptance and Commitment Therapy (KOMPACT) approach in people awaiting TKA.Methods and analysis51 community-dwelling adults scheduled for a primary TKA at two hospitals will be recruited to this pilot, mixed-methods, prospective randomised controlled trial with assessor blinding. Participants will be randomised in a 1:2 ratio to either usual care (education class) or usual care plus KOMPACT (2 hours 20 min of preoperative physiotherapy informed by Acceptance and Commitment Therapy). Our primary outcome measures are safety (length of stay, complications and psychological health after KOMPACT), acceptability (treatment credibility and qualitative data) and feasibility (recruitment, retention and intervention fidelity) of the KOMPACT approach. Secondary outcomes include health service outcomes, patient-reported physical and psychological outcomes, and physical performance measures. Quantitative data collection was conducted at baseline, 1–2 weeks before TKA, 6 weeks after TKA and 6 months after TKA. Qualitative data collection is 1–2 weeks before TKA. Data analysis will take a quantitative-led approach with triangulation after thematic analysis of the qualitative data.Ethics and disseminationThis study has full ethics approval (HREC/18/WMEAD/440). Results from this study will be published in peer-reviewed journals and presented at local and international conferences.Trial registration numberAustralia New Zealand Clinical Trials Registry (ACTRN12618001867280p).

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“…Mindfulness is a key aspect of Acceptance and Commitment Therapy [ 75 ] and this psychological approach has been shown to be more effective in older adults with chronic pain than cognitive-behavioral therapy [ 76 ]. Given the older age of the TKA population and early positive results with use of mindfulness, future research needs to explore TKA care options informed by Acceptance and Commitment Therapy [ 77 , 78 ].…”

Feasibility and Acceptability of Parenting for Lifelong Health Program in Mainland China

“…The recruitment rate was determined based on the number of potential participants who were contacted, met the inclusion criteria, passed the screening, and completed the pretest assessments following informed consent procedures (McCoy et al, 2021). The criterion for success was recruitment rates of at least 40% of those who are eligible (March et al, 2020). The retention rate was calculated as the percentage of participants who completed the intervention.…”

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“…In study 3, I developed a novel preoperative physiotherapy intervention named KOMPACT-P: Knee Osteoarthritis Management with Physiotherapy informed by Acceptance and Commitment Therapy. My pilot randomised trial assessed safety, acceptability and feasibility of the intervention as well as effectiveness outcomes 5…”

“…The pilot randomised controlled trial5 started recruitment, however, was impacted by COVID-19 restrictions. Preliminary results indicate that the intervention was safe, feasible, delivered with high fidelity and was acceptable to participants.…”