An online intervention combining home exercise and pain-coping skills training provided substantial clinical benefits for patients suffering from chronic knee pain. This model of care delivery could greatly improve patient access to effective treatments. Results of a randomized, controlled trial are published in Annals of Internal Medicine.
Knee osteoarthritis, the leading cause of chronic knee pain, causes loss of function, reduced quality of life, and psychological disability. There is no cure for osteoarthritis and given the aging population and increasing obesity, disease burden is rapidly increasing. Home-based exercise and pain-coping skills training (an approach based on cognitive behavioral principles to target psychological factors that are common in persons with chronic pain) have been shown to offer relief, but accessing specialist clinicians to prescribe and supervise these treatments may be a challenge for some patients.
Researchers tested an Internet-delivered treatment program to determine if it could improve pain and function in patients with chronic knee pain. Participants were randomly assigned to an intervention or control group. The intervention group had seven Skype sessions with a physical therapist to learn home exercises and pain-coping skills over 3 months. The control group received educational materials online. The researchers measured pain and physical functioning in both groups at baseline, 3 months, and 9 months. Participants in the intervention group reported significantly more improvement in pain and physical function than those in the control group.
The author of an accompanying editorial suggests that these findings are encouraging and show that "telemedicine" can break down barriers to care, making treatment inexpensive and easily scalable.
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More information: Study: http://annals.org/aim/article/doi/10.7326/M16-1714
Free patient summary: http://annals.org/aim/article/doi/10.7326/P17-9031