Internet-mediated physiotherapy and pain coping skills training for people with persistent knee pain (IMPACT - knee pain): a randomised controlled trial protocol.
Internet-mediated physiotherapy and pain coping skills training for people with persistent knee pain (IMPACT - knee pain): a randomised controlled trial protocol.
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DOI：
10.1186/1471-2474-15-279
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发表时间：
2014-08-13
影响因子：
2.3
通讯作者：
Bennell KL
中科院分区：
文献类型：
--
作者：
Dobson F;Hinman RS;French S;Rini C;Keefe F;Nelligan R;Abbott JH;Bryant C;Staples MP;Dalwood A;Bennell KL
50岁以上人群的持续性膝关节疼痛通常归因于膝关节骨关节炎（OA），这是一种常见的关节疾病，可导致身体和心理功能障碍。运动和疼痛应对技能培训（PCST）可以帮助减少持续性膝关节疼痛的影响，但是，获得提供这些服务的卫生专业人员可能具有挑战性。随着互联网接入的增加，远程提供的基于互联网的治疗方法可能为医疗保健提供替代方案。这项实用的随机对照试验将调查在持续性膝关节疼痛患者中，结合PCST和物理治疗师指导的运动（PCST + Ex）的互联网干预是否比在线教育材料（教育对照）更有效。我们将从澳大利亚社区招募148名50岁以上的患者，他们自我报告持续性膝关节疼痛，与膝关节OA一致。在完成基线问卷调查后，将参与者随机分配以访问为期3个月的干预，包括（i）在线教育材料，或（ii）相同的在线材料加上8个模块（每周一次）基于互联网的PCST计划和7个互联网提供的物理治疗课程，每周进行3次家庭锻炼计划。将在基线、3个月和9个月时测量结局，主要时间点为3个月。主要结局为行走时平均膝关节疼痛（11分数字评定量表）和自我报告的身体功能（西安大略和麦克马斯特大学骨关节炎指数子量表）。次要结局包括膝关节疼痛、健康相关生活质量、症状的整体变化以及结局的潜在调节因子和介导因子，包括疼痛管理和功能的自我效能、疼痛应对尝试和疼痛灾难化。将在3、6和9个月时收集其他依从性指标、不良事件、伤害、医疗服务/联合干预措施的使用和过程指标，包括干预措施的适当性和满意度。这些发现将有助于确定互联网接入的有效性和可接受性，以结合已知对持续性膝关节疼痛患者有益的干预措施。这项研究有可能指导临床实践走向创新的医疗保健提供模式。澳大利亚和新西兰临床试验注册参考：ACTRN 12614000243617。本文的在线版本（doi：10.1186/1471-2474-15-279）包含补充材料，可供授权用户使用。
Persistent knee pain in people over 50 years of age is often attributable to knee osteoarthritis (OA), a common joint condition that causes physical and psychological dysfunction. Exercise and pain coping skills training (PCST) can help reduce the impact of persistent knee pain, however, access to health professionals who deliver these services can be challenging. With increasing access to the Internet, remotely delivered Internet-based treatment approaches may provide alternatives for healthcare delivery. This pragmatic randomised controlled trial will investigate whether an Internet-delivered intervention that combines PCST and physiotherapist-guided exercise (PCST + Ex) is more effective than online educational material (educational control) in people with persistent knee pain. We will recruit 148 people over 50 years of age with self-reported persistent knee pain consistent with knee OA from the Australian community. Following completion of baseline questionnaires, participants will be randomly allocated to access a 3-month intervention of either (i) online educational material, or (ii) the same online material plus an 8-module (once per week) Internet-based PCST program and seven Internet-delivered physiotherapy sessions with a home exercise programs to be performed 3 times per week. Outcomes will be measured at baseline, 3 months and 9 months with the primary time point at 3 months. Primary outcomes are average knee pain on walking (11-point numeric rating scale) and self-reported physical function (Western Ontario and McMaster Universities Osteoarthritis Index subscale). Secondary outcomes include additional measures of knee pain, health-related quality-of-life, perceived global change in symptoms, and potential moderators and mediators of outcomes including self-efficacy for pain management and function, pain coping attempts and pain catastrophising. Other measures of adherence, adverse events, harms, use of health services/co-interventions, and process measures including appropriateness and satisfaction of the intervention, will be collected at 3, 6 and 9 months. The findings will help determine the effectiveness and acceptability of Internet access to a combination of interventions that are known to be beneficial to people with persistent knee pain. This study has the potential to guide clinical practice towards innovative modes of healthcare provision. Australian New Zealand Clinical Trials Registry reference: ACTRN12614000243617. The online version of this article (doi:10.1186/1471-2474-15-279) contains supplementary material, which is available to authorized users.