Osteoarthritis Clinical Trial
Official title:
The Effect of Flexible Tape Versus Placebo Tape in Patients Completing a Home Exercise Program With Knee Osteoarthritis
People with osteoarthritis (OA) of the knee attending The Alfred hospital will be invited to
participate in a randomised controlled trial comparing two different types of knee taping.
Both groups will also be prescribed an exercise program to assist in management of their
knee OA.
Hypothesis are as follows:
1. Participants treated with flexible tape with have greater reductions in pain and
improvements on timed performance based measures when compared to those treated with a
placebo tape.
2. Participants in both groups will have clinically significant improvements in pain and
timed performance based measures compared to their baseline scores.
Interventions:
Participants in both groups will attend physiotherapy on 4 occasions, in addition to an
initial appointment where baseline data will be collected.
All participants will be provided with an individualised home exercise program. This will be
provided based on the investigators' clinical experience and evidence based programs. The
participant will be provided with a handout detailing the exercises they are to complete,
including dosage. If there is excessive pain or difficulty associated with completing an
exercise the participant will be advised to cease that particular exercise until they have
been reviewed by the researcher the following week.
Participants will have their knee taped according to either the therapeutic flexible taping
protocol, or the placebo taping protocol depending on which group they have been randomly
allocated to on three occasions at one week intervals. All participants will be provided
with written information regarding tape allergies and when to remove the tape from their
knee. To control for the Hawthorne effect participants will not be aware of whether they are
in the intervention or placebo group.
Participants will attend for appointments once per week for three weeks. They will then have
a three week period of no intervention and return for a review and completion of the study.
At this time the participant can be referred for further physiotherapy intervention as is
clinically indicated. This may include physiotherapy at The Alfred Hospital, private
practice or the participants' local health services.
If at anytime a participant wishes to withdraw from the study they can be referred by the
investigators to continue their physiotherapy in the appropriate setting.
Sample size calculations: The investigators hypothesise that the combination of taping and
an exercise program will give rise to clinically significant improvements in functional
capacity, symptoms and quality of life. If there is truly no difference in the change in VAS
between placebo and therapeutic based groups, then 30 patients are required to be 90% sure
that the 95% confidence interval will exclude a difference in means of more than 20mm. This
has been demonstrated by Tubach and colleagues in 2005. This assumes a standard deviation of
the change in VAS of 21.5. Due to participant attrition anticipated an additional 20% will
be recruited to the sample. This will total 36 participants in total.
Feasibility: The osteoarthritis hip and knee clinic at The Alfred hospital review
approximately 13 patients per week of which the majority would be appropriate for inclusion
in this trial. There are also many referrals from orthopaedics, rheumatology and emergency
for patients who will be appropriate for inclusion. It is therefore anticipated that
recruitment to the study will not be a barrier to completion of this trial.
Statistical analysis: All data will be analysed by intention to treat. Continuous variables
will be analysed using analysis of covariance, controlling for baseline values and
recruitment centre. The proportion of participants who complete the program will be compared
between groups using a chi-squared test and the relative risk of non-completion will be
determined. Alpha will be set at 0.05
;
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