Optimization of Analgesics for Greater Exercise Therapy Participation Among Patients With Knee Osteoarthritis and Severe Pain

A Feasibility Study

Joyce van Tunen, Marike van der Leeden, Wouter H Bos, John Cheung, Martin van der Esch, Martijn Gerritsen, Wilfred F Peter, Leo D Roorda, Gerard J Tijhuis, Ramon E Voorneman, Willem F Lems, Joost Dekker

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

OBJECTIVE: Severe pain in patients with knee osteoarthritis hampers the ability to exercise. A protocol for the standardized optimization of analgesics in combination with exercise therapy was developed. The purpose of this protocol was to reduce pain, thereby allowing the patient to participate in exercise therapy. The objective of the present study was to evaluate the feasibility and outcome of the protocol.

METHODS: Forty-nine patients with knee osteoarthritis and severe knee pain (NRS-pain≥7) were included. Analgesics were prescribed following an incremental protocol. After 6 weeks a 12-week exercise therapy program was added. Information about analgesic use and exercise therapy content was recorded. Knee pain and activity limitations were assessed at baseline, after six weeks and after 18 weeks.

RESULTS: Statistically significant improvements in pain and activity limitations were found in intention-to-treat analysis after six weeks of analgesic use and after the complete intervention. Mean improvements from baseline were 30% (p<0.001) for pain and 17% (p<0.001) for activity limitations after the complete intervention. Seventy-eight percent of the patients were able to exercise according to the protocol. In these patients exercise therapy following on six weeks of analgesic use resulted in a further improvement of activity limitations of 10% (p=0.004).

CONCLUSION: The combined intervention of standardized analgesic prescription and exercise therapy allows most patients with knee osteoarthritis and severe pain to participate in exercise therapy, leading to reduction of pain and activity limitations. These promising results need to be confirmed in a randomized controlled trial. This article is protected by copyright. All rights reserved.

OriginalsprogEngelsk
TidsskriftArthritis Care & Research
Vol/bind68
Udgave nummer3
Sider (fra-til)332–340
ISSN2151-464X
DOI
StatusUdgivet - mar. 2016
Udgivet eksterntJa

Fingeraftryk

Patient Participation
Knee Osteoarthritis
Feasibility Studies
Exercise
Intention to Treat Analysis
Prescriptions
Knee
Randomized Controlled Trials

Citer dette

van Tunen, J., van der Leeden, M., Bos, W. H., Cheung, J., van der Esch, M., Gerritsen, M., ... Dekker, J. (2016). Optimization of Analgesics for Greater Exercise Therapy Participation Among Patients With Knee Osteoarthritis and Severe Pain: A Feasibility Study. Arthritis Care & Research, 68(3), 332–340. https://doi.org/10.1002/acr.22682
van Tunen, Joyce ; van der Leeden, Marike ; Bos, Wouter H ; Cheung, John ; van der Esch, Martin ; Gerritsen, Martijn ; Peter, Wilfred F ; Roorda, Leo D ; Tijhuis, Gerard J ; Voorneman, Ramon E ; Lems, Willem F ; Dekker, Joost. / Optimization of Analgesics for Greater Exercise Therapy Participation Among Patients With Knee Osteoarthritis and Severe Pain : A Feasibility Study. I: Arthritis Care & Research. 2016 ; Bind 68, Nr. 3. s. 332–340.
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title = "Optimization of Analgesics for Greater Exercise Therapy Participation Among Patients With Knee Osteoarthritis and Severe Pain: A Feasibility Study",
abstract = "OBJECTIVE: Severe pain in patients with knee osteoarthritis hampers the ability to exercise. A protocol for the standardized optimization of analgesics in combination with exercise therapy was developed. The purpose of this protocol was to reduce pain, thereby allowing the patient to participate in exercise therapy. The objective of the present study was to evaluate the feasibility and outcome of the protocol.METHODS: Forty-nine patients with knee osteoarthritis and severe knee pain (NRS-pain≥7) were included. Analgesics were prescribed following an incremental protocol. After 6 weeks a 12-week exercise therapy program was added. Information about analgesic use and exercise therapy content was recorded. Knee pain and activity limitations were assessed at baseline, after six weeks and after 18 weeks.RESULTS: Statistically significant improvements in pain and activity limitations were found in intention-to-treat analysis after six weeks of analgesic use and after the complete intervention. Mean improvements from baseline were 30{\%} (p<0.001) for pain and 17{\%} (p<0.001) for activity limitations after the complete intervention. Seventy-eight percent of the patients were able to exercise according to the protocol. In these patients exercise therapy following on six weeks of analgesic use resulted in a further improvement of activity limitations of 10{\%} (p=0.004).CONCLUSION: The combined intervention of standardized analgesic prescription and exercise therapy allows most patients with knee osteoarthritis and severe pain to participate in exercise therapy, leading to reduction of pain and activity limitations. These promising results need to be confirmed in a randomized controlled trial. This article is protected by copyright. All rights reserved.",
author = "{van Tunen}, Joyce and {van der Leeden}, Marike and Bos, {Wouter H} and John Cheung and {van der Esch}, Martin and Martijn Gerritsen and Peter, {Wilfred F} and Roorda, {Leo D} and Tijhuis, {Gerard J} and Voorneman, {Ramon E} and Lems, {Willem F} and Joost Dekker",
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van Tunen, J, van der Leeden, M, Bos, WH, Cheung, J, van der Esch, M, Gerritsen, M, Peter, WF, Roorda, LD, Tijhuis, GJ, Voorneman, RE, Lems, WF & Dekker, J 2016, 'Optimization of Analgesics for Greater Exercise Therapy Participation Among Patients With Knee Osteoarthritis and Severe Pain: A Feasibility Study', Arthritis Care & Research, bind 68, nr. 3, s. 332–340. https://doi.org/10.1002/acr.22682

Optimization of Analgesics for Greater Exercise Therapy Participation Among Patients With Knee Osteoarthritis and Severe Pain : A Feasibility Study. / van Tunen, Joyce ; van der Leeden, Marike; Bos, Wouter H; Cheung, John; van der Esch, Martin; Gerritsen, Martijn; Peter, Wilfred F; Roorda, Leo D; Tijhuis, Gerard J; Voorneman, Ramon E; Lems, Willem F; Dekker, Joost.

I: Arthritis Care & Research, Bind 68, Nr. 3, 03.2016, s. 332–340.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Optimization of Analgesics for Greater Exercise Therapy Participation Among Patients With Knee Osteoarthritis and Severe Pain

T2 - A Feasibility Study

AU - van Tunen, Joyce

AU - van der Leeden, Marike

AU - Bos, Wouter H

AU - Cheung, John

AU - van der Esch, Martin

AU - Gerritsen, Martijn

AU - Peter, Wilfred F

AU - Roorda, Leo D

AU - Tijhuis, Gerard J

AU - Voorneman, Ramon E

AU - Lems, Willem F

AU - Dekker, Joost

N1 - © 2015, American College of Rheumatology.

PY - 2016/3

Y1 - 2016/3

N2 - OBJECTIVE: Severe pain in patients with knee osteoarthritis hampers the ability to exercise. A protocol for the standardized optimization of analgesics in combination with exercise therapy was developed. The purpose of this protocol was to reduce pain, thereby allowing the patient to participate in exercise therapy. The objective of the present study was to evaluate the feasibility and outcome of the protocol.METHODS: Forty-nine patients with knee osteoarthritis and severe knee pain (NRS-pain≥7) were included. Analgesics were prescribed following an incremental protocol. After 6 weeks a 12-week exercise therapy program was added. Information about analgesic use and exercise therapy content was recorded. Knee pain and activity limitations were assessed at baseline, after six weeks and after 18 weeks.RESULTS: Statistically significant improvements in pain and activity limitations were found in intention-to-treat analysis after six weeks of analgesic use and after the complete intervention. Mean improvements from baseline were 30% (p<0.001) for pain and 17% (p<0.001) for activity limitations after the complete intervention. Seventy-eight percent of the patients were able to exercise according to the protocol. In these patients exercise therapy following on six weeks of analgesic use resulted in a further improvement of activity limitations of 10% (p=0.004).CONCLUSION: The combined intervention of standardized analgesic prescription and exercise therapy allows most patients with knee osteoarthritis and severe pain to participate in exercise therapy, leading to reduction of pain and activity limitations. These promising results need to be confirmed in a randomized controlled trial. This article is protected by copyright. All rights reserved.

AB - OBJECTIVE: Severe pain in patients with knee osteoarthritis hampers the ability to exercise. A protocol for the standardized optimization of analgesics in combination with exercise therapy was developed. The purpose of this protocol was to reduce pain, thereby allowing the patient to participate in exercise therapy. The objective of the present study was to evaluate the feasibility and outcome of the protocol.METHODS: Forty-nine patients with knee osteoarthritis and severe knee pain (NRS-pain≥7) were included. Analgesics were prescribed following an incremental protocol. After 6 weeks a 12-week exercise therapy program was added. Information about analgesic use and exercise therapy content was recorded. Knee pain and activity limitations were assessed at baseline, after six weeks and after 18 weeks.RESULTS: Statistically significant improvements in pain and activity limitations were found in intention-to-treat analysis after six weeks of analgesic use and after the complete intervention. Mean improvements from baseline were 30% (p<0.001) for pain and 17% (p<0.001) for activity limitations after the complete intervention. Seventy-eight percent of the patients were able to exercise according to the protocol. In these patients exercise therapy following on six weeks of analgesic use resulted in a further improvement of activity limitations of 10% (p=0.004).CONCLUSION: The combined intervention of standardized analgesic prescription and exercise therapy allows most patients with knee osteoarthritis and severe pain to participate in exercise therapy, leading to reduction of pain and activity limitations. These promising results need to be confirmed in a randomized controlled trial. This article is protected by copyright. All rights reserved.

U2 - 10.1002/acr.22682

DO - 10.1002/acr.22682

M3 - Journal article

VL - 68

SP - 332

EP - 340

JO - Arthritis Care & Research

JF - Arthritis Care & Research

SN - 2151-464X

IS - 3

ER -