Osteo Arthritis Knee Clinical Trial
Official title:
Joint Loading vs Normal Physiotherapy Care in Degenerative Knees (V1)
This study is a randomised controlled clinical trial designed to evaluate the effectiveness
of two different exercise based treatments in the management of patients with knee problems
related to degenerative (wear and tear) changes.
Recent evidence suggests that putting weight through a joint (joint loading) may be
beneficial.
The Investigators know that physiotherapy and exercise is important in treating these
patients, but the investigators do not know which exercises work best. In this study the
investigators will be comparing current physiotherapy care against a new programme of
exercises that gradually increases the amount of joint loading.
The study will recruit approximately 140 patients from the Leeds Musculoskeletal (MSK)
service, who are over the age of 45 and have been referred for physiotherapy by their GP for
activity related knee pain.Patients who are suitable and happy to take part will be selected
randomly (not chosen by the patient or physiotherapist) to receive either normal
physiotherapy treatment, or the knee loading exercises. The treatment phase will last for
six weeks and participants will be asked to carry out their exercises twice daily during
this time. At the end of this period, patients will be asked tocomplete questionnaires and
again at six months so that the investigators can assess how the patients are doing.
The main aim is to evaluate clinical effectiveness of the progressive joint loading
protocol. However, the data collected will also be used to see if there is a way of
identifying in advance those who might respond better to either treatment.
The investigators will also collect some information relating to the cost effectiveness of
delivering different treatments. The final aim of this study is to test how easy it is to
collect more detailed data in this area if a related study were to be carried out in the
future.
The Leeds University academic partner will provide statistical support for the study team during the data analysis phase. Predictor variables with a substantial single variable association with each outcome (p<0.2) will be included in a multivariable linear regression model to determine the adjusted associations of improved outcome from being in the treatment arm. A second model will use multi-levels (two levels: 1. time points for individuals, 2. individuals) to determine whether the trajectory of change in outcome scores differs between the two arms of the study. Significant predictors of improved outcomes will be determined from both of these models. A sensitivity analysis will be undertaken for final models based on degrees of compliance to home treatment using categories determined through exploratory analysis of the data. ;
Allocation: Randomized, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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