Trial Outcomes & Findings for Pain Informed Movement for People With Knee Osteoarthritis (NCT NCT05730829)
NCT ID: NCT05730829
Last Updated: 2025-04-16
Results Overview
The follow-up rate is calculated as the number (percentage) of participants who completed the study out of those who completed the baseline assessment.
Recruitment status
COMPLETED
Study phase
NA
Target enrollment
69 participants
Primary outcome timeframe
8 weeks
Results posted on
2025-04-16
Participant Flow
NA. we did not have any significant event prior to assignment of participants to an arm.
Participant milestones
| Measure |
Pain Informed Movement and Pain Neuroscience Education
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
|
Standard Neuromuscular Exercise and OA Education
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
|
|---|---|---|
|
Overall Study
STARTED
|
34
|
35
|
|
Overall Study
COMPLETED
|
28
|
31
|
|
Overall Study
NOT COMPLETED
|
6
|
4
|
Reasons for withdrawal
Withdrawal data not reported
Baseline Characteristics
Pain Informed Movement for People With Knee Osteoarthritis
Baseline characteristics by cohort
| Measure |
Pain Informed Movement and Pain Neuroscience Education
n=28 Participants
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
|
Standard Neuromuscular Exercise and OA Education
n=31 Participants
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
|
Total
n=59 Participants
Total of all reporting groups
|
|---|---|---|---|
|
Age, Continuous
|
64 years
STANDARD_DEVIATION 9 • n=5 Participants
|
62 years
STANDARD_DEVIATION 10 • n=7 Participants
|
63 years
STANDARD_DEVIATION 10 • n=5 Participants
|
|
Sex: Female, Male
Female
|
23 Participants
n=5 Participants
|
19 Participants
n=7 Participants
|
42 Participants
n=5 Participants
|
|
Sex: Female, Male
Male
|
5 Participants
n=5 Participants
|
12 Participants
n=7 Participants
|
17 Participants
n=5 Participants
|
|
Race (NIH/OMB)
American Indian or Alaska Native
|
25 Participants
n=5 Participants
|
28 Participants
n=7 Participants
|
53 Participants
n=5 Participants
|
|
Race (NIH/OMB)
Asian
|
2 Participants
n=5 Participants
|
2 Participants
n=7 Participants
|
4 Participants
n=5 Participants
|
|
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
|
1 Participants
n=5 Participants
|
1 Participants
n=7 Participants
|
2 Participants
n=5 Participants
|
|
Race (NIH/OMB)
Black or African American
|
0 Participants
n=5 Participants
|
0 Participants
n=7 Participants
|
0 Participants
n=5 Participants
|
|
Race (NIH/OMB)
White
|
0 Participants
n=5 Participants
|
0 Participants
n=7 Participants
|
0 Participants
n=5 Participants
|
|
Race (NIH/OMB)
More than one race
|
0 Participants
n=5 Participants
|
0 Participants
n=7 Participants
|
0 Participants
n=5 Participants
|
|
Race (NIH/OMB)
Unknown or Not Reported
|
0 Participants
n=5 Participants
|
0 Participants
n=7 Participants
|
0 Participants
n=5 Participants
|
PRIMARY outcome
Timeframe: 8 weeksPopulation: This is the number of participants at baseline who completed the baseline assessments and enrolled in the study.
The follow-up rate is calculated as the number (percentage) of participants who completed the study out of those who completed the baseline assessment.
Outcome measures
| Measure |
Pain Informed Movement and Pain Neuroscience Education
n=34 Participants
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
|
Standard Neuromuscular Exercise and OA Education
n=35 Participants
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
|
|---|---|---|
|
Percentage of Follow up
|
28 Participants
|
31 Participants
|
SECONDARY outcome
Timeframe: 8 weeksthe number of participants who found the program useful or very useful. Participants rated the program's usefulness on a Likert scale, ranging from "Not useful at all" to "Very useful." The final count reflects those who selected either of the top two response categories, indicating a positive perception of the program's value.
Outcome measures
| Measure |
Pain Informed Movement and Pain Neuroscience Education
n=28 Participants
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
|
Standard Neuromuscular Exercise and OA Education
n=31 Participants
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
|
|---|---|---|
|
Number of Participants Who Considered the Program Useful and Very Useful
|
25 Participants
|
29 Participants
|
SECONDARY outcome
Timeframe: 8 weeksThis outcome measure represents the number of participants who rated the program's frequency as "Frequent enough" on a 5-point Likert scale. The scale ranged from "Not frequent enough" to "Frequent enough," capturing participants' satisfaction with the program's scheduling.
Outcome measures
| Measure |
Pain Informed Movement and Pain Neuroscience Education
n=28 Participants
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
|
Standard Neuromuscular Exercise and OA Education
n=31 Participants
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
|
|---|---|---|
|
Number of Participants Who Considered the Program Frequent Enough
|
24 Participants
|
25 Participants
|
SECONDARY outcome
Timeframe: 8 weeksThis outcome measure represents the number of participants who rated the frequency of the educational sessions as "Frequent enough" on a 5-point Likert scale. The scale ranged from "Not frequent enough" to "Frequent enough," assessing participants' satisfaction with the scheduling of the sessions.
Outcome measures
| Measure |
Pain Informed Movement and Pain Neuroscience Education
n=28 Participants
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
|
Standard Neuromuscular Exercise and OA Education
n=31 Participants
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
|
|---|---|---|
|
Number of Participants Who Considered the Educational Session Frequency Enough
|
24 Participants
|
25 Participants
|
SECONDARY outcome
Timeframe: 1 yearrecruitment rate is a minimum of 40 people in a year
Outcome measures
| Measure |
Pain Informed Movement and Pain Neuroscience Education
n=34 Participants
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
|
Standard Neuromuscular Exercise and OA Education
n=35 Participants
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
|
|---|---|---|
|
Rate of Recruitment Measured by Number of People Recruited in a Year
|
28 Participants
|
31 Participants
|
SECONDARY outcome
Timeframe: 8 weeksPopulation: The percentage of the participants per arm who did not find the study procedures burdensome.
This outcome measure represents the percentage of participants who rated the program's burdensomeness as zero, using a scale from 0 ("No burden at all") to 10 ("Very much a burden"). Participants who provided a low burden rating (≤3/10) are included in this percentage, indicating that they did not perceive the program as burdensome.
Outcome measures
| Measure |
Pain Informed Movement and Pain Neuroscience Education
n=28 Participants
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
|
Standard Neuromuscular Exercise and OA Education
n=31 Participants
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
|
|---|---|---|
|
Percentage of Participants Who Did Not Find the Study Procedures Burdensome (Questionnaires, Tests, Blood Draws) Measured on 0-10 Scale
Burden of questionnaires
|
69 percentage of the participants
|
87 percentage of the participants
|
|
Percentage of Participants Who Did Not Find the Study Procedures Burdensome (Questionnaires, Tests, Blood Draws) Measured on 0-10 Scale
Burden of physical assessments
|
83 percentage of the participants
|
94 percentage of the participants
|
SECONDARY outcome
Timeframe: 8 weeksPopulation: This is the total number of possible sessions for each group (16 sessions \* Number of participants per group)
This outcome measure evaluates adherence to the program by calculating the number of sessions attended in-person and the number of home sessions completed by participants. The rate of adherence is determined by the proportion of sessions attended and completed relative to the total number of scheduled sessions.
Outcome measures
| Measure |
Pain Informed Movement and Pain Neuroscience Education
n=448 Number of sessions
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
|
Standard Neuromuscular Exercise and OA Education
n=496 Number of sessions
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
|
|---|---|---|
|
Rate of Adherence Measured by Number of Sessions Attended and Home Sessions Completed
|
396 number of sessions attended in each grou
|
425 number of sessions attended in each grou
|
SECONDARY outcome
Timeframe: 8 weeksmeasured as any problem that lasts for \>2 days and/or causes the participant to seek other treatment
Outcome measures
| Measure |
Pain Informed Movement and Pain Neuroscience Education
n=28 Participants
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
|
Standard Neuromuscular Exercise and OA Education
n=31 Participants
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
|
|---|---|---|
|
Rate of Adverse Events Measured by Question Regarding Symptom Flare and Seeking Treatment
|
0 Number of adverse events
|
0 Number of adverse events
|
OTHER_PRE_SPECIFIED outcome
Timeframe: baselineto assesses the presence of comorbidities minimum score = 0, maximum = 20 with higher scores indicating greater severity.
Outcome measures
Outcome data not reported
OTHER_PRE_SPECIFIED outcome
Timeframe: baselinePopulation: Ethnicity: Caucasian n (%)
Ethnicity
Outcome measures
| Measure |
Pain Informed Movement and Pain Neuroscience Education
n=28 Participants
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
|
Standard Neuromuscular Exercise and OA Education
n=31 Participants
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
|
|---|---|---|
|
Participant Characteristics
|
25 Participants
|
28 Participants
|
OTHER_PRE_SPECIFIED outcome
Timeframe: baseline and 8 weeksWeight
Outcome measures
Outcome data not reported
OTHER_PRE_SPECIFIED outcome
Timeframe: baseline and 8 weeksThis outcome measure represents the number of participants who reported taking any medication on a regular schedule. Medication use was assessed with a yes/no response, where participants indicated whether they consistently take any prescribed or over-the-counter medications.
Outcome measures
| Measure |
Pain Informed Movement and Pain Neuroscience Education
n=28 Participants
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
|
Standard Neuromuscular Exercise and OA Education
n=31 Participants
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
|
|---|---|---|
|
Number of Participants With Medication Use
Baseline
|
18 Participants
|
9 Participants
|
|
Number of Participants With Medication Use
8 weeks
|
16 Participants
|
10 Participants
|
OTHER_PRE_SPECIFIED outcome
Timeframe: baseline and 8 weeksThree questions will be asked: 1. Are your knee symptoms so severe that you wish to undergo knee replacement surgery? 2. Do you think knee replacement surgery is eventually inevitable? 3. In your opinion, what factor(s) can lead to better outcomes after knee replacement surgery?
Outcome measures
Outcome data not reported
OTHER_PRE_SPECIFIED outcome
Timeframe: baseline and 8 weeksUsing a body diagram, participants will be asked to indicate any other areas where they experience pain
Outcome measures
| Measure |
Pain Informed Movement and Pain Neuroscience Education
n=28 Participants
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
|
Standard Neuromuscular Exercise and OA Education
n=31 Participants
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
|
|---|---|---|
|
Other Painful Body Parts
Baselin
|
3.6 mean number of painful joints
Standard Deviation 2.8
|
2.9 mean number of painful joints
Standard Deviation 1.9
|
|
Other Painful Body Parts
8 weeks
|
4 mean number of painful joints
Standard Deviation 3.9
|
2.36 mean number of painful joints
Standard Deviation 1.5
|
OTHER_PRE_SPECIFIED outcome
Timeframe: baseline and 8 weeksA 512mN weighted probe was applied at the volar wrist opposite to the index knee. Participants were asked to rate their pain on a scale from 0 (no pain) to 100 (worst imaginable pain). Then, the same stimulus was applied 10 times at a rate of 1 per second (guided by a metronome), and participants were again asked to rate their pain. Temporal Summation (TS) was defined as present if the pain rating after the repeated stimuli was higher than the initial pain rating. The TS score was calculated as the difference between the pain rating after the repeated stimuli and the initial pain rating at each timepoint.
Outcome measures
| Measure |
Pain Informed Movement and Pain Neuroscience Education
n=28 Participants
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
|
Standard Neuromuscular Exercise and OA Education
n=31 Participants
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
|
|---|---|---|
|
Mechanical Temporal Summation (TS)
Follow-up
|
1.6 score on a scale
Standard Deviation 1.4
|
1.7 score on a scale
Standard Deviation 1.4
|
|
Mechanical Temporal Summation (TS)
Baseline
|
1.8 score on a scale
Standard Deviation 1.6
|
2.02 score on a scale
Standard Deviation 1.54
|
OTHER_PRE_SPECIFIED outcome
Timeframe: baseline and 8 weeksFirst stimulus of pressure pain threshold is delivered, next ischemic forearm test is conducted to a 4/10 and then PPT is repeated. An index will be created by calculating the percent efficiency of CPM (%CPM) as PPT2/PPT1, multiplied by 100; whereby %CPM ≤ 100 indicates inefficient pain modulation CPM. There are no standard minimum or maximum values.
Outcome measures
| Measure |
Pain Informed Movement and Pain Neuroscience Education
n=28 Participants
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
|
Standard Neuromuscular Exercise and OA Education
n=31 Participants
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
|
|---|---|---|
|
Conditioned Pain Modulation (CPM) Measured With PPT Test Stimulus and Conditioning Stimulus of Forearm Ischemia
Baselin
|
110.4 score on a scale
Standard Deviation 23.7
|
102.2 score on a scale
Standard Deviation 34.7
|
|
Conditioned Pain Modulation (CPM) Measured With PPT Test Stimulus and Conditioning Stimulus of Forearm Ischemia
Follow-up
|
120 score on a scale
Standard Deviation 33.4
|
109.1 score on a scale
Standard Deviation 32.2
|
OTHER_PRE_SPECIFIED outcome
Timeframe: baseline and 8 weeksThis outcome measure assesses pain intensity using the Numeric Rating Scale (NRS), where participants rate their pain on a scale from 0 to 10, with higher scores indicating greater pain severity. Three ratings are recorded: average pain intensity in the past 24 hours, average pain intensity in the past week, and worst pain intensity in the past 24 hours.
Outcome measures
| Measure |
Pain Informed Movement and Pain Neuroscience Education
n=28 Participants
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
|
Standard Neuromuscular Exercise and OA Education
n=31 Participants
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
|
|---|---|---|
|
Pain Intensity Measured on the Numeric Rating Scale (NRS)
Baseline Pain in the past 24 hours
|
4.2 score on a scale
Standard Deviation 1.7
|
3.5 score on a scale
Standard Deviation 1.9
|
|
Pain Intensity Measured on the Numeric Rating Scale (NRS)
Baseline Pain in the past week
|
4.2 score on a scale
Standard Deviation 1.4
|
3.8 score on a scale
Standard Deviation 1.9
|
|
Pain Intensity Measured on the Numeric Rating Scale (NRS)
Baseline worse pain in the past 24 hours
|
4.9 score on a scale
Standard Deviation 1.8
|
3.9 score on a scale
Standard Deviation 2.4
|
|
Pain Intensity Measured on the Numeric Rating Scale (NRS)
Follow up Pain in the past 24 hours
|
3.0 score on a scale
Standard Deviation 2.2
|
2.8 score on a scale
Standard Deviation 1.8
|
|
Pain Intensity Measured on the Numeric Rating Scale (NRS)
Follow-up Pain in the past week
|
3.3 score on a scale
Standard Deviation 1.6
|
3.1 score on a scale
Standard Deviation 1.7
|
|
Pain Intensity Measured on the Numeric Rating Scale (NRS)
Follow up worse pain in the past 24 hours
|
3.5 score on a scale
Standard Deviation 2.7
|
3.2 score on a scale
Standard Deviation 2.2
|
OTHER_PRE_SPECIFIED outcome
Timeframe: baseline and 8 weeks13 questions for a total score of 52 with higher scores indicating more severe symptoms. Minimum score = 0, maximum score 52
Outcome measures
| Measure |
Pain Informed Movement and Pain Neuroscience Education
n=28 Participants
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
|
Standard Neuromuscular Exercise and OA Education
n=31 Participants
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
|
|---|---|---|
|
Pain Catastrophizing Scale (PCS)
Baseline
|
11.2 score on a scale
Standard Deviation 9.6
|
9.4 score on a scale
Standard Deviation 9.1
|
|
Pain Catastrophizing Scale (PCS)
Follow-up
|
7.4 score on a scale
Standard Deviation 7.4
|
11.1 score on a scale
Standard Deviation 6.8
|
OTHER_PRE_SPECIFIED outcome
Timeframe: baseline and 8 weeksmeasure of self-efficacy rated on 0-10 scale ranging from not at all confident to entirely confident
Outcome measures
| Measure |
Pain Informed Movement and Pain Neuroscience Education
n=28 Participants
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
|
Standard Neuromuscular Exercise and OA Education
n=31 Participants
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
|
|---|---|---|
|
Self-Efficacy for Managing Chronic Disease 6-item Scale (SEMCD-6)
Baseline
|
7.0 score on a scale
Standard Deviation 1.5
|
6.8 score on a scale
Standard Deviation 1.8
|
|
Self-Efficacy for Managing Chronic Disease 6-item Scale (SEMCD-6)
Follow-up
|
7.4 score on a scale
Standard Deviation 1.9
|
7.1 score on a scale
Standard Deviation 2
|
OTHER_PRE_SPECIFIED outcome
Timeframe: baseline and 8 weeksThis outcome measure assesses symptoms of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS). The HADS consists of 14 items, with seven items assessing anxiety (HADS-A) and seven assessing depression (HADS-D). Each item is scored on a 0 to 3 scale, resulting in total scores ranging from 0 to 21 for both anxiety and depression subscales. Higher scores indicate greater levels of anxiety or depression,
Outcome measures
| Measure |
Pain Informed Movement and Pain Neuroscience Education
n=28 Participants
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
|
Standard Neuromuscular Exercise and OA Education
n=31 Participants
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
|
|---|---|---|
|
Hospital Anxiety and Depression Scale (HADS)
Anxiety Baseline
|
5.2 score on a scale
Standard Deviation 3.2
|
4.9 score on a scale
Standard Deviation 3.0
|
|
Hospital Anxiety and Depression Scale (HADS)
Depression Baseline
|
3.6 score on a scale
Standard Deviation 2.3
|
4.9 score on a scale
Standard Deviation 3.0
|
|
Hospital Anxiety and Depression Scale (HADS)
Anxiety Follow-up
|
5.2 score on a scale
Standard Deviation 3.1
|
4.2 score on a scale
Standard Deviation 3.6
|
|
Hospital Anxiety and Depression Scale (HADS)
Depression follow-up
|
3.7 score on a scale
Standard Deviation 2.3
|
3.8 score on a scale
Standard Deviation 2.9
|
OTHER_PRE_SPECIFIED outcome
Timeframe: Baseline and 8 weeksThis outcome measure assesses fear of movement (kinesiophobia) in individuals with osteoarthritis using the Brief Fear of Movement Scale for Osteoarthritis (BFMSO). The BFMSO consists of six items derived from the Tampa Scale for Kinesiophobia (TSK) and is rated on a 4-point Likert scale (1-4), with a total score range of 6 to 24, where higher scores indicate greater levels of kinesiophobia. The scale evaluates concerns about movement due to pain or the fear of worsening symptoms, providing insight into the psychological barriers that may affect physical activity and rehabilitation adherence in individuals with osteoarthritis.
Outcome measures
| Measure |
Pain Informed Movement and Pain Neuroscience Education
n=28 Participants
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
|
Standard Neuromuscular Exercise and OA Education
n=31 Participants
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
|
|---|---|---|
|
Brief Fear of Movement Scale for Osteoarthritis (BFMSO)
Baseline
|
10.3 Total score on a scale
Standard Deviation 2.7
|
10.4 Total score on a scale
Standard Deviation 3.1
|
|
Brief Fear of Movement Scale for Osteoarthritis (BFMSO)
Follow-up
|
11.8 Total score on a scale
Standard Deviation 2.1
|
10.7 Total score on a scale
Standard Deviation 3.1
|
OTHER_PRE_SPECIFIED outcome
Timeframe: baseline and 8 weeksThe KOOS pain and function in daily living and QoL subscales were used to assess self-reported opinions about patients' knee and associated problems. Scores ranged from 0-100 with zero representing extreme knee problems and 100 representing no knee problems
Outcome measures
| Measure |
Pain Informed Movement and Pain Neuroscience Education
n=28 Participants
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
|
Standard Neuromuscular Exercise and OA Education
n=31 Participants
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
|
|---|---|---|
|
Knee Injury and Osteoarthritis Outcome Score (KOOS)
Pain baseline
|
55.3 score on a scale
Standard Deviation 12.7
|
60.9 score on a scale
Standard Deviation 14
|
|
Knee Injury and Osteoarthritis Outcome Score (KOOS)
Function baseline
|
70.5 score on a scale
Standard Deviation 12.1
|
71.2 score on a scale
Standard Deviation 13.2
|
|
Knee Injury and Osteoarthritis Outcome Score (KOOS)
QL baseline
|
23.6 score on a scale
Standard Deviation 15.9
|
19.7 score on a scale
Standard Deviation 16.8
|
|
Knee Injury and Osteoarthritis Outcome Score (KOOS)
Pain follow-up
|
67.4 score on a scale
Standard Deviation 13.5
|
57.7 score on a scale
Standard Deviation 14.6
|
|
Knee Injury and Osteoarthritis Outcome Score (KOOS)
Function follow-up
|
77.2 score on a scale
Standard Deviation 12.1
|
76.7 score on a scale
Standard Deviation 14.9
|
|
Knee Injury and Osteoarthritis Outcome Score (KOOS)
Ql- follow up
|
28.1 score on a scale
Standard Deviation 14
|
26.6 score on a scale
Standard Deviation 15.2
|
OTHER_PRE_SPECIFIED outcome
Timeframe: baseline and 8 weeksThe ICOAP (Intermittent and Constant Osteoarthritis Pain) Knee Version assesses two distinct types of knee pain: constant pain and intermittent pain. The constant pain subscale consists of five items that evaluate pain that is present all the time. Each item is rated on a scale from 0 to 4, where 0 represents no pain, 1 indicates mild pain, 2 corresponds to moderate pain, 3 signifies severe pain, and 4 represents extreme pain. The total score for this subscale ranges from 0 to 20, with higher scores reflecting greater pain severity. Similarly, the intermittent pain subscale comprises six items that assess pain that comes and goes in episodes. Each item follows the same 0 to 4 rating scale, capturing the intensity of episodic pain experiences. The total score for this subscale ranges from 0 to 24. The overall ICOAP knee score is the sum of both subscales, resulting in a total score range of 0 to 44, where higher scores indicate more severe and impactful knee pain.
Outcome measures
| Measure |
Pain Informed Movement and Pain Neuroscience Education
n=28 Participants
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
|
Standard Neuromuscular Exercise and OA Education
n=31 Participants
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
|
|---|---|---|
|
Intermittent and Constant Osteoarthritis Pain (ICOAP) Knee Version
Constant Pain - Baseline
|
6.9 score on a scale
Standard Deviation 3.3
|
5.5 score on a scale
Standard Deviation 3.9
|
|
Intermittent and Constant Osteoarthritis Pain (ICOAP) Knee Version
Intermittent Pain- Baseline
|
10.2 score on a scale
Standard Deviation 4.0
|
10.4 score on a scale
Standard Deviation 3.6
|
|
Intermittent and Constant Osteoarthritis Pain (ICOAP) Knee Version
Constant Pain - Follow-up
|
4.4 score on a scale
Standard Deviation 3.4
|
4.2 score on a scale
Standard Deviation 3.7
|
|
Intermittent and Constant Osteoarthritis Pain (ICOAP) Knee Version
Intermittent Pain- Follow up
|
7.5 score on a scale
Standard Deviation 4.2
|
7 score on a scale
Standard Deviation 3.8
|
|
Intermittent and Constant Osteoarthritis Pain (ICOAP) Knee Version
Total Score Baseline
|
17.2 score on a scale
Standard Deviation 6.3
|
16.1 score on a scale
Standard Deviation 7.1
|
|
Intermittent and Constant Osteoarthritis Pain (ICOAP) Knee Version
Total Score Follow up
|
11.8 score on a scale
Standard Deviation 7.3
|
11.1 score on a scale
Standard Deviation 6.7
|
OTHER_PRE_SPECIFIED outcome
Timeframe: baseline and 8 weeksto measure functional leg strength and endurance by counting the numbers of complete movements accomplished in the allotted time
Outcome measures
| Measure |
Pain Informed Movement and Pain Neuroscience Education
n=28 Participants
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
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Standard Neuromuscular Exercise and OA Education
n=31 Participants
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
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30 Second Sit to Stand Test
Baseline
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13.8 repetitions
Standard Deviation 3.3
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11.9 repetitions
Standard Deviation 2.6
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30 Second Sit to Stand Test
Follow-up
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17 repetitions
Standard Deviation 4
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15 repetitions
Standard Deviation 4
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OTHER_PRE_SPECIFIED outcome
Timeframe: baseline and 8 weeksa neurotrophin level measured in pg/ml
Outcome measures
| Measure |
Pain Informed Movement and Pain Neuroscience Education
n=28 Participants
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
|
Standard Neuromuscular Exercise and OA Education
n=31 Participants
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
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|---|---|---|
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Serum Levels of Brain Derived Neurotrophic Factors (BDNF) Via Blood Analysis
Baseline
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39.7 picograms per milliliter
Standard Deviation 8.9
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39.3 picograms per milliliter
Standard Deviation 11.2
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Serum Levels of Brain Derived Neurotrophic Factors (BDNF) Via Blood Analysis
Follow-up
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40.3 picograms per milliliter
Standard Deviation 9
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39.1 picograms per milliliter
Standard Deviation 10.2
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OTHER_PRE_SPECIFIED outcome
Timeframe: baseline and 8 weeksa neurotrophin level measured in pg/ml
Outcome measures
| Measure |
Pain Informed Movement and Pain Neuroscience Education
n=28 Participants
Participants will engage in a twice-weekly, 8-week in-person group exercise program, combining neuromuscular exercise and mind-body techniques. Each session includes 75 minutes of exercise instruction and, during the first four weeks, 20 to 30 minutes of Pain Neuroscience Education (PNE) videos. A third weekly home session will be supported by exercise handouts. The exercise component will be led by an experienced yoga instructor trained extensively in pain-informed movement, incorporating techniques such as breath regulation, muscle tension regulation, relaxation, mindfulness, and awareness of pain-related thoughts and emotions.
The PNE videos will cover key topics: the purpose of pain, neurophysiological changes in pain, movement strategies when pain persists, and self-care techniques to influence neurophysiology. These include breath awareness, muscle tension regulation, and relaxation methods aimed at supporting movement with greater ease while fostering body awareness and emotional regulation.
|
Standard Neuromuscular Exercise and OA Education
n=31 Participants
Participants in this group will receive an 8-week in-person group exercise program held twice weekly, in which they will receive exercise instructions (60 minutes) and standard osteoarthritis (OA) education (15 to 20 minutes/week for the first 4 weeks). A third home session (weekly) will be facilitated by exercise handout sheets. The exercise component (i.e., the specific movements) of this group will be similar to those of the other group without the added techniques of breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, relaxation, and body awareness. The standard OA education videos will cover the following topics: common OA symptoms, risk factors associated with knee OA, and the effects of exercise and self-management tips. The exercise and education components will be delivered by a physiotherapist in the research team.
standard neuromuscular exercise: group classes twice weekly for 8 weeks of neuromuscular exercise.
Standard osteoarthritis (OA) education: The standard osteoarthritis (OA) education will address the following topics, OA prevalence, risk factors, symptoms, diagnosis, treatment, role of exercise, surgery, self-management
|
|---|---|---|
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Serum Levels of Nerve Growth Factor (NGF) Via Blood Analysis
Baseline
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614 picograms per milliliter
Standard Deviation 1436
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534 picograms per milliliter
Standard Deviation 1426
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Serum Levels of Nerve Growth Factor (NGF) Via Blood Analysis
Follow-up
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587 picograms per milliliter
Standard Deviation 1460
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521 picograms per milliliter
Standard Deviation 1564
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OTHER_PRE_SPECIFIED outcome
Timeframe: 8 weeksOne question will be asked of participants in each arm to rank the effectiveness of the different components of the intervention they received. e.g. "Please rank the different components of the intervention you received in order of how effective they are for managing your pain." A list of the different components in each study arm will be provided e.g. education videos, strengthening exercise, mind-body techniques
Outcome measures
Outcome data not reported
Adverse Events
Pain Informed Movement and Pain Neuroscience Education
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Standard Neuromuscular Exercise and OA Education
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Serious adverse events
Adverse event data not reported
Other adverse events
Adverse event data not reported
Additional Information
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place