Predictors for Analgesic Effect to Standardized Exercise Therapy for Osteoarthritic Pain

Kristian Kjær Petersen

Status: Completed

Conditions: Healthy Subjects; Osteoarthritis, Knee

Treatments: Other: Part 2: Military training; Other: Physiotherapy-guided Evidence-based Exercise Therapy

Study type: Observational

Funder types: Other

Identifiers

NCT03718663

N-20170070

Details and patient eligibility

About

Pain sensitization has been associated with pain severity in people with knee osteoarthritis (KOA) and a neuropathic pain component has been identified in up to 30% of KOA patients. In addition, exercise-induced hypoalgesia (EIH), a measure of descending pain control, has previously been found dysfunctional in a subgroup of people with painful KOA and has also been utilized as a predictive factor for pain progression following total knee replacement.

Measures of pain sensitization have been used prognostic to identify responders to treatment but EIH as a prognostic tool for Physiotherapy-guided Evidence-based Exercise Therapy (PEET) has not been investigated. The primary aim of this explorative study is to investigate if EIH assessed pre-PEET was associated with changes in pain, disability and PainDETECT (PDQ) score post-PEET. The secondary aim is to investigate if PEET changes EIH and PDQ score in patients with painful KOA.

Part 2:

Cross-sectional studies indicate, that daily level of activity influence the effectivity of the EIH mechanims, while pain patients (e.g. KOA patients) can have normal of dysfunctional EIH. It has not been investigated if EIH changes after prolonged exercise in healthy subjects. The aim of this secord part of the study, is to investigate if EIH changes after 6-9 weeks of intensive military training in healthy subjects

Enrollment: 28 patients

Sex: All

Ages: 50+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• The American College of Rheumatology for clinical knee osteoarthritis (excluding radiological OA assessment)

Exclusion criteria

• Known factors to influence pain and pain sensitization.

Part 2:

Inclusion Criteria

• starting as recruits in Defence Command Denmark

Exclusion Criteria:

• Known factors to influence pain and pain sensitization.

Trial design

28 participants in 2 patient groups

Knee OA patients (part 1)

Description:

Painful knee OA patients signed up for standardized exercise therapy

Treatment:

Other: Physiotherapy-guided Evidence-based Exercise Therapy

Healthy subjects (part 2)

Description:

Healthy subjects (age 18-28) signed up military service in Defence Command Denmark

Treatment:

Other: Part 2: Military training