Effectiveness of a cognitive-behavioural group intervention for knee osteoarthritis pain: A randomized controlled trial

BMC Musculoskeletal Disorders (Impact Factor: 1.72). 01/2013; 14(1):46. DOI: 10.1186/1471-2474-14-46
Source: PubMed


Objective: To assess the effectiveness of a six week cognitive-behavioural group intervention in patients with knee osteoarthritis pain. Design: Single-blinded randomized controlled trial. Study setting: Primary care providers in a medium-sized city in Finland. Patients: A total of 111 participants aged from 35 to 75 with clinical symptoms and radiographic grading (Kellgren-Lawrence 2-4) of knee osteoarthritis were included. Interventions: In the intervention group, 55 participants attended a cognitive-behavioural training programme for pain management with six weekly group sessions supervised by a psychologist and a physiotherapist. Concurrently, they and the 56 participants of the control group continued in ordinary GP care that was not altered by the study. Main measures: The primary outcome on three-month and 12-month follow-up was the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis index pain subscale. Secondary outcome measures included self-reports of pain and physical function, health-related quality of life, and a comprehensive set of psychological questionnaires. Results: Mixed model results showed no significant differences between the intervention and control group for any measures of pain or function. A significant difference between the groups was found in the Pain Self-Efficacy Questionnaire (Pr=0.022) in favour of the control group, and in the RAND-36 emotional well-being subscale in favour of the intervention group (Pr=0.038). Conventional group comparisons of mean follow-up values showed no significant differences in any of the outcome variables. Conclusion: This trial could not confirm the hypothesized advantage of a cognitive-behavioural training programme over ordinary GP care in knee osteoarthritis pain patients. Trial registration: Current Controlled Trials ISRCTN64794760

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Available from: Sanna Sinikallio, Mar 11, 2014
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