Moderators of Effects of Internet-Delivered Exercise and Pain Coping Skills Training for People With Knee Osteoarthritis: Exploratory Analysis of the IMPACT Randomized Controlled Trial (Preprint)

BACKGROUND Internet-delivered exercise, education, and pain coping skills training is effective for people with knee osteoarthritis, yet it is not clear whether this treatment is better suited to particular subgroups of patients. OBJECTIVE The aim was to explore demographic and clinical moderators of the effect of an internet-delivered intervention on changes in pain and physical function in people with knee osteoarthritis. METHODS Exploratory analysis of data from 148 people with knee osteoarthritis who participated in a randomized controlled trial comparing internet-delivered exercise, education, and pain coping skills training to internet-delivered education alone. Primary outcomes were changes in knee pain while walking (11-point Numerical Rating Scale) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index function subscale) at 3 and 9 months. Separate regression models were fit with moderator variables (age, gender, expectations of outcomes, self-efficacy [pain], education, employment status, pain catastrophizing, body mass index) and study group as covariates, including an interaction between the two. RESULTS Participants in the intervention group who were currently employed had significantly greater reductions in pain at 3 months than similar participants in the control group (between-group difference: mean 2.38, 95% CI 1.52-3.23 Numerical Rating Scale units; interaction P=.02). Additionally, within the intervention group, pain at 3 months reduced by mean 0.53 (95% CI 0.28-0.78) Numerical Rating Scale units per unit increase in baseline self-efficacy for managing pain compared to mean 0.11 Numerical Rating Scale units (95% CI –0.13 to 0.35; interaction P=.02) for the control group. CONCLUSIONS People who were employed and had higher self-efficacy at baseline were more likely to experience greater improvements in pain at 3 months after an internet-delivered exercise, education, and pain coping skills training program. There was no evidence of a difference in the effect across gender, educational level, expectation of treatment outcome, or across age, body mass index, or tendency to catastrophize pain. Findings support the effectiveness of internet-delivered care for a wide range of people with knee osteoarthritis, but future confirmatory research is needed. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12614000243617; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365812&isReview=true (Archived by WebCite at http://www.webcitation.org/6z466oTPs)

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Caregiver-guided pain coping skills training for patients with advanced cancer: Background, design, and challenges for the CaringPals study

Clinical Trials ◽

10.1177/1740774519829695 ◽

2019 ◽

Vol 16 (3) ◽

pp. 263-272 ◽

Cited By ~ 3

Author(s):

Laura S Porter ◽

Gregory Samsa ◽

Jennifer L Steel ◽

Laura C Hanson ◽

Thomas W LeBlanc ◽

...

Keyword(s):

Psychological Distress ◽

Family Caregivers ◽

Advanced Cancer ◽

Self Efficacy ◽

Coping Skills ◽

Skills Training ◽

Training Intervention ◽

Pain Coping ◽

Coping Skills Training ◽

Training Interventions

Background/Aims Pain is a major concern of patients with advanced cancer and their caregivers. There is strong evidence that pain coping skills training interventions based on cognitive-behavioral principles can reduce pain severity and pain interference. However, few such interventions have been tested for patients with advanced cancer and their family caregivers. This study aims to test the efficacy of a caregiver-guided pain coping skills training protocol on patient and caregiver outcomes. Methods A total of 214 patients age ≥18 with Stage III–Stage IV cancer and moderate to severe pain, along with their family caregivers, are being identified and randomized with a 1:1 allocation to the caregiver-guided pain coping skills training intervention or enhanced treatment-as-usual. Dyads in both conditions receive educational resources on pain management, and the caregiver-guided pain coping skills training intervention includes three weekly 60-min sessions conducted with the patient–caregiver dyad via videoconference. Measures of caregiver outcomes (self-efficacy for helping the patient manage pain, caregiver strain, caregiving satisfaction, psychological distress) and patient outcomes (self-efficacy for pain management, pain intensity and interference, psychological distress) are collected at baseline and post-intervention. Caregiver outcomes are also collected 3 and 6 months following the patient’s death. The study is enrolling patients from four tertiary care academic medical centers and one free-standing hospice and palliative care organization. The primary outcome is caregiver self-efficacy for helping the patient manage pain. Results This article describes challenges in the design and implementation of the CaringPals trial. Key issues for trial design include the identification and recruitment of patients with advanced cancer and pain, and the follow-up and collection of data from caregivers following the patient’s death. Conclusion The CaringPals trial addresses a gap in research in pain coping skills training interventions by addressing the unique needs of patients with advanced cancer and their caregivers. Findings from this study may lead to advances in the clinical care of patients with advanced cancer and pain, as well as a better understanding of the effects of training family caregivers to help patients cope with pain.

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A physiotherapist-delivered integrated exercise and pain coping skills training intervention for individuals with knee osteoarthritis: a randomised controlled trial protocol

BMC Musculoskeletal Disorders ◽

10.1186/1471-2474-13-129 ◽

2012 ◽

Vol 13 (1) ◽

Cited By ~ 20

Author(s):

Kim L Bennell ◽

Yasmin Ahamed ◽

Christina Bryant ◽

Gwendolen Jull ◽

Michael A Hunt ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Knee Osteoarthritis ◽

Coping Skills ◽

Controlled Trial ◽

Skills Training ◽

Training Intervention ◽

Trial Protocol ◽

Pain Coping ◽

Coping Skills Training ◽

Randomised Controlled

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A physiotherapist-delivered, combined exercise and pain coping skills training intervention for individuals with knee osteoarthritis: A pilot study

The Knee ◽

10.1016/j.knee.2012.07.008 ◽

2013 ◽

Vol 20 (2) ◽

pp. 106-112 ◽

Cited By ~ 47

Author(s):

Michael A. Hunt ◽

Francis J. Keefe ◽

Christina Bryant ◽

Ben R. Metcalf ◽

Yasmin Ahamed ◽

...

Keyword(s):

Pilot Study ◽

Knee Osteoarthritis ◽

Coping Skills ◽

Skills Training ◽

Training Intervention ◽

Pain Coping ◽

Coping Skills Training ◽

Combined Exercise

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Effectiveness of the quadriceps strengthening exercise on pain and functional ability of the women with Osteoarthritis (OA)

International Journal of Current Research in Chemistry and Pharmaceutical Sciences ◽

10.22192/ijcrcps.2021.08.09.001 ◽

2021 ◽

Vol 8 (9) ◽

pp. 1-6

Author(s):

Absar Ahmed Qureshi ◽

◽

Shadia Hamoud Alshahrani ◽

Premalatha Paulsamy ◽

Krishnaraju Venkatesan ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Functional Ability ◽

Rating Scale ◽

Numerical Rating Scale ◽

Exercise Group ◽

Control Group ◽

Timed Up And Go ◽

Strengthening Exercise ◽

Study Results ◽

Numerical Rating

A Quasi experimental design was adopted for this study to find out the effectiveness of quadriceps strengthening exercise program on pain and functional ability of women with knee osteoarthritis (OA). Fifty women with OA were selected in which first 25 women were enrolled in the control group and second 25 women were allotted in the exercise group. Assessments were performed at baseline and at 8 weeks. The functional ability was assessed using the Timed Up and Go (TUG) test and Numerical Rating Scale (NRS) was used to assess the pain level .For the exercise group, quadriceps strengthening exercises were taught and asked the patients to follow the exercise schedule for 8 weeks. The study results show that the pain and functional abilty scores were improved in the exercise group and the difference was statistically significant (p<0.001). The study concluded that a simple quadriceps strengthening exercise programme can significantly improve self reported knee pain and functional ability among women with Knee osteoarthritis. Keywords: Osteoarthritis, Pain, Functional Ability, Exercise, Quadriceps strengthening, Timed Up and Go (TUG) test, Numerical Rating Scale (NRS)

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Effectiveness of pain coping skills training on pain, physical function, and psychological outcomes in patients with osteoarthritis: A systemic review and meta-analysis

Clinical Rehabilitation ◽

10.1177/0269215520968251 ◽

2020 ◽

pp. 026921552096825

Author(s):

Lin Wang ◽

Liming Zhang ◽

Lin Yang ◽

He Cheng-qi

Keyword(s):

Clinical Trials ◽

Adverse Events ◽

Coping Skills ◽

Skills Training ◽

Psychological Outcomes ◽

Mean Difference ◽

Systemic Review ◽

Control Group ◽

Pain Coping ◽

Coping Skills Training

Objective: To investigate the effectiveness of pain coping skills training in pain, function, and psychological outcomes for patients with osteoarthritis, compared to the control group; and to compare the effectiveness of pain coping skills training between the intervention involving and without involving exercise. Data sources: PubMed, Embase, the Cochrane Library, PEDro, Clinical Trials, and the WHO Clinical Trials Registry Platform (to 30 September 2020). Review methods: To calculate the results, we used standardized mean difference, and mean difference for the outcomes of continuous variables, risk difference for the risk of adverse events. Heterogeneity was identified with I2 test, and publication bias was identified with Egger’s test. Results: A total of 1195 patients with osteoarthritis underwent ten trials were included. The intervention group had significant differences in pain (SMD = −0.18; 95% CI −0.29 to −0.06), function (SMD = −0.19; −0.30 to −0.07), coping attempts (SMD = 0.37; 0.24 to 0.49), pain catastrophizing (SMD = −0.16; −0.29 to −0.02), and self-efficacy (SMD = 0.27; 0.07 to 0.46) than the control group. Between-group differences measured by the McMaster Universities Osteoarthritis Index subscales of pain (MD = −0.62; −1.48 to 0.24) or function (MD = −3.01; −6.26 to 0.24) were not statistically significant and did not reach the minimal clinically important differences that have been established. Subgroup analyses revealed no significant subgroup differences. Besides, no specific intervention-related adverse events were identified. Conclusion: Our results supported the effectiveness and safety of pain coping skills training for managing osteoarthritis in pain, function, and psychological aspects. Besides, exercise could not add benefits when combined with pain coping skills training.

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