Coping skills training and exercise 'can help knee osteoarthritis patients'

People with knee osteoarthritis could benefit from receiving pain coping skills training (PCST) in addition to a programme of exercise.

This is according to a new study from Australia, which was led by the University of Melbourne, and suggested that a combination of both of these support methods, provided by physical therapists, could deliver more benefits than either intervention on its own.

The benefits of more holistic care

A total of 222 people with knee osteoarthritis aged 50 and above were involved in the study, which saw all participants receive ten treatment sessions over 12 weeks, plus a home programme.

The PCST programme included pain education and training in cognitive and behavioural pain coping skills, while the exercise regimen involved mostly strengthening exercises. A total of 186 participants were followed for 52 weeks to ascertain the long-term impact.

At week 12, there were no significant differences for reductions in pain between those receiving the PCST, those involved in the exercise programme and those receiving both. However, data published in the journal Arthritis Care & Research showed significantly greater improvements in physical function were found for those in the PCST plus exercise group at week 12, with these differences persisting at weeks 32 and 52.

Potential cost issues

This indicates that physical therapists could help patients recover their mobility more effectively by combining these two methods. However, a note of caution was sounded over the potential expenses involved in doing so, as the cost-effectiveness of the combined method was not demonstrated by this study.

The researchers concluded: "This model of care could improve access to psychological treatment and augment patient outcomes from exercise in knee osteoarthritis, although it did not appear to be cost-effective."

Katherine Free, research liaison and communications manager for Arthritis Research UK, said: "This is an interesting study that demonstrates the importance of exercise and mental wellbeing for pain management.

"Arthritis Research UK has funded the development of a web-based exercise programme that will allow people with chronic knee pain to access a rehabilitation programme called ESCAPE-pain. This programme combines education, self-management and coping advice with simple exercises and has been shown to improve pain, mobility and daily activities. In addition, it has been shown to result in reduced treatment costs."

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