New Physiotherapy Intervention for People With Knee Osteoarthritis
Current physiotherapy treatments for knee osteoarthritis focus on muscle strengthening and provide only small-moderate improvements in pain. Therefore, this project aimed to develop a new treatment to reduce the pain associated with knee osteoarthritis. The new treatment is called “Cognitive Muscular Therapy (CMT)” and is an integrated behavioural intervention which combines psychologically informed practice with muscle biofeedback training. The aim of CMT is to reduce muscle overactivity, minimise mechanical loading on the knee during daily activities and change beliefs related to knee osteoarthritis pain.
The intervention uses EMG (electromyography) biofeedback, animated instructional videos and tailored muscle awareness procedures to teach patients to move with less muscle overactivity. Using these digital tools, the physiotherapist guides the patient through a gradual relearning process, in which they first learn to stand and then perform daily tasks, such as walking, with less muscle overactivity. Patients also learn to change the way they think about and react to pain. For more information about this new techniques see our dedicated webpage.
To date, we have run two small studies which suggest that CMT might be able to bring about large improvements in knee osteoarthritis pain. We are now running a large NIHR-funded trial to test the CMT intervention. This trial will recruit 252 patients, half of which will recieve the CMT intervention. The results will be ready in 2028. If this trial shows large reductions in pain, the this intervention will hopefully be across the NHS and in private physiotherapy practice.
This work is part of a larger portfolio of projects which seeks to understand the biomechanical drivers of altered muscle coordination in people with knee osteoarthritis. We want to use this understanding to develop new tools to enable physiotherapist to teach patients to improve their muscle patterns.
Funder:
NIHR RfPB
Team:
Mr Nathan Brookes (Salford Royal)
Dr Chelsea Starbuck