| Author, Year, Followup,a Pain Duration, Study Quality | Intervention | Population | Function and Pain Outcomes | Other Outcomes |
|---|---|---|---|---|
Bennell, 2016134 5 and 9 months Duration of pain: 6 years Fair | A. Pain coping skills training (n=74): 10, 45-minute sessions over 12 weeks; consisted of pain education and cognitive and behavioral pain coping skills training B. Exercise (n=75): 10, 25 minute sessions over 12 week; consisted of 6 strengthening exercises. | A vs. B Age, years: 63 vs. 63 Female: 61% vs. 59% Radiographic disease severity: Grade 2: 45% vs. 40% Grade 3: 28% vs. 25% Grade 4: 27% vs. 35% Opioid use: 4% vs. 1% Baseline WOMAC physical function (0-68): 35.0 vs. 34.3 Baseline WOMAC pain (0-20): 8.7 vs. 8.6 Baseline pain overall VAS (0-100): 58.7 vs. 59.1 Baseline pain with walking VAS (0-100): 61.3 vs. 60.9 | A vs. B 5 months WOMAC physical function: 23.4 vs. 21.4, difference 2.0 (95% CI −2.4 to 6.4) WOMAC pain: 6.2 vs. 6.3, difference −0.1 (95% CI −1.2 to 1.0) Pain overall VAS: 35.7 vs. 36.0, difference −0.3 (95% CI −9.0 to 8.4) Pain with walking VAS: 39.1 vs. 42.3, difference −3.2 (95% CI −12.4 to 6.0) 9 months WOMAC physical function: 21.3 vs. 18.1, difference 3.2 (95% CI −0.6 to 7.0) WOMAC pain: 5.8 vs. 5.4, difference 0.4 (95% CI −0.8 to 1.6) Pain overall VAS: 34.8 vs. 34.5, difference 0.3 (95% CI −7.8 to 8.4) Pain with walking VAS: 37.3 vs. 37.5, difference −0.2 (95% CI −9.1 to 8.7) | A vs. B 5 months DASS21 depression scale (0-42): 4.3 vs. 5.5, difference −1.2 (95% CI −4.0 to 1.6) DASS21 anxiety scale (0-42): 4.0 vs. 4.9, difference −0.6 (95% CI −3.0 to 1.2) AQoL-6D (−0.04 to 1.0): 0.79 vs. 0.76, difference 0.03 (95% CI −0.02 to 0.09) 9 months DASS21 depression scale: 3.5 vs. 4.9, difference −1.4 (95% CI −3.6 to 0.8) DASS21 anxiety scale: 3.0 vs. 4.6, difference −1.6 (95% CI −3.4 to 0.2) AQoL-6D: 0.81 vs. 0.78, difference 0.03 (95% CI −0.02 to 0.08) Percent of patients using opioids: 10% (7/72) vs. 13% (9/71), RR 0.77 (95% CI 0.3 to 1.9) |
Gilbert, 2018111 3, 6, 12, and 24 months Mean duration of pain: NR Fair [New trial] | A. IMPAACT Motivational Interviewing (MI) (n=76) 1 initial session (45 to 60 minutes long), and 5 additional sessions (10 to 15 minutes long) B. No treatment (n=79) All patients: received brief physician consultation with recommendation to increase physical activity | A vs. B Age: 61 vs. 65 Female: 58% vs. 62% Mean duration of Chronicity: 9.6 vs. 12.1 years Baseline WOMAC Function (0-68): 18.0 vs. 17.4 Baseline WOMAC Pain (0-20): 5.9 vs. 5.5 | A vs. B 3 months WOMAC Function: 16.5 (95% CI 14.7 to 18.4) vs. 17.8 (95% CI 16.3, 19.4); difference 1.3 (95% CI −1.1 to 3.7) WOMAC Pain: 5.2 (95% CI 4.6 to 5.8) vs. 6.1 (95% CI 5.6 to 6.7); difference 1.0 (95% CI 0.2 to 1.8) 6 months WOMAC Function: 15.1 (95% CI 13.1 to 17.2) vs. 16.7 (95% CI 15.1 to 18.3); difference 1.6 (95% CI −1.0 to 4.2) WOMAC Pain: 5.3 (95% CI 4.6 to 6.0) vs. 5.5 (95% CI 4.9 to 6.0); difference 0.18 (95% CI −0.7 to 1.1) 12 months WOMAC Function: 13.4 (95% CI 11.1 to 15.7) vs. 16.6 (95% CI 14.6 to 18.6); difference 3.2 (95% CI 0.1 to 6.2) WOMAC Pain: 4.8 (95% CI 4.0 to 5.5) vs. 5.7 (95% CI 5.0 to 6.4); difference 0.9 (95% CI −0.1 to 1.9) 24 months WOMAC Function: 12.5 (95% CI 10.1 to 14.9) vs. 15.3 (95% CI 12.6, 18.1); difference 2.8 (95% CI −0.8 to 6.4) WOMAC Pain: 4.0 (95% CI 3.2 to 4.7) vs. 4.7 (95% CI 3.8 to 5.7); difference 0.8 (95% CI −0.4 to 2.0) | A vs. B 3 months SF-36 PCS (0-100): 46.0 (95% CI 44.7 to 47.3) vs. 44.7 (95% CI 43.2 to 46.2); difference 1.4 (95% CI −0.6 to 3.4) SF-36 MCS (0-100): 54.0 (95% CI 52.3 to 55.6) vs. 54.6 (95% CI 52.8 to 56.4); difference −0.6 (95% CI −3.1 to 1.8) 6 months SF-36 PCS: 45.0 (95% CI 43.6 to 46.5) vs. 44.8 (95% CI 43.5 to 46.2); difference 0.23 (95% CI −1.8 to 2.2) SF-36 MCS: 54.3 (95% CI 52.5 to 56.1) vs. 54.1 (95% CI 52.2 to 55.9); difference 0.3 (95% CI −2.3 to 2.8) 12 months SF-36 PCS: 46.0 (95% CI 44.6 to 47.5) vs. 44.3 (95% CI 42.6 to 46.0); difference 1.7 (95% CI −0.5 to 3.9) SF-36 MCS: 54.1 (95% CI 51.9 to 56.2) vs. 54.7 (95% CI 52.9 to 56.4); difference −0.6 (95% CI −3.4 to 2.1) 24 months SF-36 PCS: 45.4 (95% CI 43.4 to 47.5) vs. 44.7 (95% CI 42.3 to 47.0); difference 0.78 (95% CI −2.3 to 3.9) SF-36 MCS: 54.2 (95% CI 52.0 to 56.3) vs. 52.8 (95% CI 50.0 to 55.6); difference 1.3 (95% CI −2.16 to 4.8) |
Helminen, 2015109 31.5 to 10.5 months Duration of pain: 7.8 years Fair | Cognitive-Behavioral Training plus usual care (n=55): 2-hour groups sessions, weekly for 6 weeks (6 sessions total); included attention diversion methods (relaxation, imagery, distraction), activity-rest cycling and pleasant activity scheduling, cognitive restructuring, and homework assignments B. Usual Care (n=56) | A vs. B Age: 64.5 vs. 63 years Female: 71% vs. 68% BMI: 30 vs. 30 kg/m2 Bilateral knee OA: 33% vs. 30% Kellgren-Lawrence grade 2: 60% vs. 61% Duration of Chronicity: 6.6 vs. 8.9 years Baseline WOMAC Function (0-100): 53.0 vs. 48.4 Baseline WOMAC Pain (0-100): 57.6 vs. 56.4 Baseline NRS pain (0-10), average past week: 6.6 vs. 6.4 Baseline NRS pain (0-10), worst past week: 8.0 vs. 7.5 Baseline NRS pain (0-10), average 3 months: 6.8 vs. 6.6 Baseline NRS pain (0-10), worst 3 months: 8.2 vs. 8.0 | A vs. B Post-Treatment Average (1.5 to 10.5 months) WOMAC Function: 36.5 vs. 36.7, difference −0.3 (95% CI −8.3 to 7.8) WOMAC Pain: 35.6 vs. 39.5, difference −3.9 (95% CI −11.8 to 4.0) NRS pain, average past week: 5.0 vs. 4.9, difference 0.02 (95% CI −0.89 to 0.93) NRS pain, worst over week: 6.1 vs. 5.9, difference 0.1 (95% CI −0.8 to 1.1) NRS pain, average 3 months: 5.2 vs. 5.4 difference −0.2 (95% CI −1.0 to 0.6) NRS pain, worst 3 months: 6.4 vs. 6.6, difference −0.1 (95% CI −0.9 to 0.7) | A vs. B Post-Treatment Average (1.5 to 10.5 months) WOMAC Stiffness (0-100): 46.2 vs. 49.0 difference −2.7 (95% CI −11.4 to 5.9) BDI (0−63): 5.8 vs. 5.9, difference −0.1 (95% CI −2.2 to 2.0) BAI (0−63): 8.0 vs. 7.1, difference 0.9 (95% CI −1.3 to 3.1) HRQoL, 15D (scale NR): 0.82 vs. 0.85, difference −0.03 (95% CI −0.06 to 0.00) SF-36 Physical Functioning (scale NR): 48.0 vs. 49.4 difference −1.4 (95% CI −10.2 to 7.3) SF-36 Role-Physical: 44.4 vs. 44.5 difference −0.09 (95% CI −14.4 to 14.3) SF-36 Bodily Pain: 57.3 vs. 57.4, difference −0.1 (95% CI −8.0 to 7.7) SF-36 General Health: 53.1) vs. 58.2, difference −5.0 (95% CI −12.3 to 2.3) SF-36 Vitality: 62.7 vs. 67.5, difference −4.8 (95% CI −12.6 to 3.1) SF-36 Social Functioning: 75.0 vs. 82.8, difference −7.8 (95% CI −16.4 to 0.81) SF-36 Role-Emotional: 67.9 vs. 74.7, difference −6.7 (95% CI −20.2 to 6.8) SF-36 Emotional Well-Being: 75.3 vs. 78.5, difference −3.2 (95% CI −9.5 to 3.1) SF-36 Health Change: 46.6 vs. 47.4, difference −0.8 (95% CI −9.2 to 7.6) |
O’Moore, 2018112 3 months Duration of pain: NR Fair [New trial] | A. iCBT (n=43) B. Usual Care (n=24) | A vs. B Age: 63 vs. 60 years Female: 86% vs. 68% Baseline WOMAC-ADL (0-68): 32.3 vs. 30.0 Baseline WOMAC-Stiffness (0-8): 4.5 vs. 4.2 Baseline WOMAC-Pain (0-20): 9.9 vs. 9.4 | A vs. B 3 months WOMAC-ADL: 24.1 vs. 30.34; difference −6.3 (95% CI −11.9 to −0.7), p<0.05 WOMAC-Stiffness: 3.3 vs. 4.4, difference −1.1 (95% CI −2.0 to −0.3), p<0.05; WOMAC-Pain: 7.4 vs. 9.8; difference −2.34 (95% CI −4.2 to −0.5), p<0.05 | NR |
Somers, 2012110 6-12 months Duration of pain: NR Poor | A. Pain Coping Skills Training (n=60): 1-hour group sessions, weekly for 12 weeks then every other week for 12 weeks (total of 18 sessions over 24 weeks); consisted of informational lectures, problem solving, skills training, relaxation exercises, homework assignments, and feedback B. Usual Care (n=51) | A vs. B Age: 58 vs. 58 years Female: 67% vs. 78% Caucasian: 62% vs. 61% Mean Duration of Chronicity: NR Kellgren-Lawrence score (0-4): 2.5 vs. 2.3 Baseline WOMAC function subscale (0-100): 46.2 vs. 46.1 Baseline WOMAC pain subscale (0-100): 42.8 vs. 43.4 | A vs. B Post-treatment Average (6-12 months) WOMAC function: 35.2 vs. 37.5, p=NS AIMS physical disability subscale: 1.5 vs. 1.4, p=NS WOMAC pain subscale: 34.5 vs. 38.0, p=NS | A vs. B Post-treatment Average (6-12 months) WOMAC stiffness subscale (0-100): 44.5 vs. 46.4, p=NS |
ADL = Activities of Daily Living; AIMS = Arthritis Impact Measurement Scale; AQoL = Assessment of Quality of Life; BAI = Beck Anxiety Inventory; BDI = Beck Depression Inventory; CI = confidence interval; DASS21 = Depression, Anxiety, and Stress Scales 21 item quesitonaire; HRQoL = health-related quality of life; iCBT = internet-based cognitive-behavioral therapy; NR = not reported; NRS = numeric rating scale; NS = not statistically significant; OA = osteoarthritis; SF-36 MCS = Short-Form 36 Mental Component Score; SF-36 PCS = Short-Form 36 Physical Component Score; RR = risk ratio; VAS = Visual Analog Scale; WOMAC = Western Ontario and McMaster Universities Osteoarthritis index
Unless otherwise noted, followup time is calculated from the end of the treatment period
From: Results
NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.