Evidence map›Paper›PMID 38419024›Full record

ArticlePilot and feasibility studies2024

Exercise therapy, education, and cognitive behavioral therapy alone, or in combination with total knee arthroplasty, in patients with knee osteoarthritis: a randomized feasibility study.

Turid Rognsvåg, Ingvild Buset Bergvad, Ove Furnes, Kari Indrekvam, Anners Lerdal, Maren Falch Lindberg, Søren T Skou, Jan Stubberud, Mona Badawy

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pilot and feasibility studies, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03771430 (A Multidisciplinary Intervention in Total Knee Arthroplasty - a Multicenter, Randomized Controlled Trial in OA Patients), which is not on this map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03771430 nacompletednot on this map

A Multidisciplinary Intervention in Total Knee Arthroplasty - a Multicenter, Randomized Controlled Trial in OA Patients (The MultiKnee Trial)

TypeinterventionalSponsorLovisenberg Diakonale HospitalRan2019 to 2026Enrolled282ConditionsOsteoarthritis, Primary, Degenerative Joint Disease of KneeArmsOsteoarthritis education, exercise and CBT, Total Knee Arthroplasty
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Turid RognsvågDepartment of Orthopedic Surgery, Haukeland University Hospital, Coastal Hospital in Hagevik, Bergen, Norway. turid.rognsvag@helse-bergen.no.ORCID http://orcid.org/0000-0001-7295-9171
Ingvild Buset BergvadDepartment of Surgery, Lovisenberg Diaconal Hospital, Oslo, Norway.
Ove FurnesDepartment of Clinical Medicine, University of Bergen, Bergen, Norway.
Kari IndrekvamDepartment of Orthopedic Surgery, Haukeland University Hospital, Coastal Hospital in Hagevik, Bergen, Norway.
Anners LerdalDepartment of Interdisciplinary Health Sciences, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.
Maren Falch LindbergDepartment of Surgery, Lovisenberg Diaconal Hospital, Oslo, Norway.
Søren T SkouResearch Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Jan StubberudDepartment of Psychology, University of Oslo, Oslo, Norway.
Mona BadawyDepartment of Orthopedic Surgery, Haukeland University Hospital, Coastal Hospital in Hagevik, Bergen, Norway.

Funding

H2020 Mobilize 801790Helse Sør-Øst RHF 2022007Helse Vest Regionalt Helseføretak 912210Horizon 2020 945377Norges Forskningsråd 287816/H10
6 · The paper itself

Abstract

backgroundOne in five patients experience chronic pain 1 year after total knee arthroplasty (TKA), highlighting the need for enhanced treatment strategies to improve outcomes. This feasibility trial aimed to optimize the content and delivery of a complex intervention tailored to osteoarthritis (OA) patients at risk of poor outcome after TKA and assess the feasibility of initiating a full-scale multicenter randomized controlled trial (RCT).

methodsPatients scheduled for TKA were included between August 2019 and June 2020 and block-randomized into one of three groups: (a) 12-week exercise therapy and education (ExE) and 10-module internet-delivered cognitive behavioral therapy (iCBT), (b) TKA followed by ExE and iCBT and (c) TKA and standard postoperative care. Outcomes were (i) recruitment and retention rate, (ii) compliance to the intervention and follow-up, (iii) crossover, and (iv) adverse events, reported by descriptive statistics.

resultsFifteen patients were included in the study. Only 1 out of 146 patients screened for eligibility was included during the first 4 months. During the next 3 months, 117 patients were not included since they lived too far from the hospital. To increase the recruitment rate, we made three amendments to the inclusion criteria; (1) at-risk screening of poor TKA outcome was removed as an eligibility criterion, (2) patients across the country could be included in the study and (3) physiotherapists without specific certification were included, receiving thorough information and support. No patients withdrew from the study or crossed over to surgery during the first year. Nine out of 10 patients completed the ExE program and six out of 10 completed the iCBT program. Fourteen out of 15 patients completed the 1-year follow-up. One minor adverse event was registered.

conclusionsExcept for recruitment and compliance to iCBT, feasibility was demonstrated. The initial recruitment process was challenging, and necessary changes were made to increase the recruitment rate. The findings informed how a definitive RCT should be undertaken to test the effectiveness of the complex intervention.

trial registrationThe MultiKnee RCT, including the feasibility study, is pre-registered at ClinicalTrials.gov: NCT03771430 11/12/2018.

Indexed as

Cognitive behavioral therapyFeasibility trialKnee osteoarthritisPhysical exercises

Identifiers

PMID38419024
PMCPMC10900652

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.