Group Physical Therapy Classes for Osteoarthritis Pain

Overseen By Vicki Jones

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Missouri-Columbia

Disqualifiers: Pregnant, Prisoners

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 3 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 3

Duration: 6 months

10000 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines how group physical therapy classes can reduce pain for individuals with knee, hip, and ankle joint pain. Participants will attend low-impact exercise sessions three times a week to improve strength and movement. The trial also includes consultations with a dietitian and a behavioral health specialist. It suits those who can regularly attend these classes and have joint pain affecting their daily life. As an unphased trial, this study offers a unique opportunity to explore innovative approaches to managing joint pain through a holistic program.

Do I have to stop taking my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that group physical therapy classes are safe for individuals with osteoarthritis pain?

Research has shown that group physical therapy classes are generally safe for people with osteoarthritis. These classes effectively manage pain and improve movement in individuals with joint issues, such as those in the knee or hip. Importantly, studies have not reported any major safety concerns.

Since the trial involves a supervised exercise program rather than a new drug or surgery, the risk of serious side effects remains low. Participants typically handle these programs well, experiencing improvements in their condition without significant negative effects.

In summary, group physical therapy classes offer a safe option for managing osteoarthritis pain. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Unlike the standard osteoarthritis treatments, which typically involve medication or invasive procedures, group physical therapy classes offer a non-invasive and holistic approach. These classes focus on improving strength and function through low-impact exercises, specifically designed for those with joint pain. Researchers are excited about these sessions because they provide social support and motivation from peers, which can enhance adherence and potentially lead to better outcomes in managing pain and improving mobility.

What evidence suggests that group physical therapy classes are effective for osteoarthritis pain?

Research shows that group physical therapy classes, which participants in this trial will attend, can reduce pain and improve movement for people with osteoarthritis, especially in the knees. Studies have found that these classes gently increase strength, which is important for managing joint pain. One study found that people in group therapy experienced noticeable improvements in pain and overall physical ability. This method not only alleviates pain but also fosters a supportive environment, boosting motivation and commitment to exercise. Overall, group physical therapy is a helpful approach for managing osteoarthritis pain. ^{1 2 3 6 7}

Are You a Good Fit for This Trial?

This trial is for adults over 18 with knee, hip, or ankle pain who can attend low-impact exercise classes three times a week for six months and also go to dietitian and behavioral health sessions. It's not open to prisoners or pregnant individuals.

Inclusion Criteria

I can attend diet and mental health classes for 6 months.

I can attend classes 3 times a week for 6 months and maintain at least a 66% attendance.

I experience pain in my knee, ankle, or hip.

Exclusion Criteria

You are pregnant.

Prisoners

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in low-impact group exercise classes three times weekly, paired with dietitian and behavioral health consults

6 months

3 visits per week (in-person)

Follow-up

Participants are monitored for changes in BMI and VAS pain scores after the treatment phase

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Group Physical Therapy Classes

Trial Overview The study tests if low-impact group exercise classes combined with standard care from dietitians and mental health professionals can reduce joint pain in the knee, hip, or ankle.

How Is the Trial Designed?

Group I: Group Physical Therapy Class Experimental Treatment 1 Intervention

Group Physical Therapy Classes. Three times weekly, these subjects will have one hour group physical therapy sessions with either a physical therapist, physical therapy assistant, or personal trainer. These sessions will be aimed to improve strength and function in a low-impact setting designed specifically for those with joint pain.

Group Physical Therapy Classes is already approved in United States, European Union, Canada for the following indications:

Approved in United States as Physical Therapy Group Sessions for:

• Ankle pain
• Knee pain
• Hip pain
• Musculoskeletal rehabilitation

Approved in European Union as Group Exercise Classes for:

• Musculoskeletal disorders
• Rehabilitation programs
• Pain management

Approved in Canada as Low-Impact Exercise Programs for:

• Chronic pain management
• Musculoskeletal health
• Rehabilitation services

Who Is Running the Clinical Trial?

University of Missouri-Columbia

Lead Sponsor

Trials

387

Recruited

629,000+

Published Research Related to This Trial

Manual physical therapy and exercise have been shown to significantly improve function and reduce pain in patients with osteoarthritis, making them effective treatment options.

Various physical therapy methods, including thermal modalities, electrotherapy, therapeutic ultrasound, and balneotherapy, provide positive therapeutic effects and should be recommended as part of osteoarthritis treatment guidelines.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Physical therapy of osteoarthritis]. Kladny, B.[2018]

Group physiotherapy after joint replacement surgery resulted in similar recovery outcomes as individualized home physiotherapy, with no significant differences in key measures like pain and function at 12 weeks post-surgery.

The group physiotherapy approach was more time-efficient, allowing patients to receive more frequent sessions while requiring less time from physiotherapists per visit, making it a cost-effective option without compromising patient care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Group physiotherapy provides similar outcomes for participants after joint replacement surgery as 1-to-1 physiotherapy: a sequential cohort study. Coulter, CL., Weber, JM., Scarvell, JM.[2009]

In a randomized controlled trial of 237 patients with non-specific low back pain, both the group exercise programme (Back to Fitness) and individual physiotherapy showed no significant differences in improving disability scores at both three and twelve months.

Patients from materially deprived areas experienced less improvement in their back pain compared to those from more affluent areas, suggesting that socioeconomic factors may influence treatment outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized trial comparing a group exercise programme for back pain patients with individual physiotherapy in a severely deprived area. Carr, JL., Klaber Moffett, JA., Howarth, E., et al.[2016]

The enhanced transtheoretical model intervention (ETMI) significantly reduced back pain-related disability in patients with chronic low back pain compared to usual physical therapy, with a mean difference of 2.7 points on the Roland-Morris Disability Questionnaire after 12 months.

Patients receiving ETMI also reported better outcomes in pain intensity, physical activity, and physical health, while requiring fewer therapy sessions (3.5 for ETMI vs. 5.1 for controls), indicating a more efficient approach to treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Increasing Recreational Physical Activity in Patients With Chronic Low Back Pain: A Pragmatic Controlled Clinical Trial. Ben-Ami, N., Chodick, G., Mirovsky, Y., et al.[2017]

A group exercise program for 40 subjects with knee osteoarthritis led to significant improvements in pain and physical function, with over 90% of scores showing positive changes after the program without increasing medication or fatigue.

Participants also experienced significant increases in gait velocity, cadence, and stride length, which were maintained two months after the program, indicating lasting benefits from the exercise intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A revised group exercise program for osteoarthritis of the knee. Fransen, M., Margiotta, E., Crosbie, J., et al.[2019]

Group-based physiotherapy-led self-management interventions (GPSMI) for osteoarthritis (OA) and chronic low back pain (CLBP) are as effective as individual physiotherapy or standard medical management, based on a review of 22 studies.

Further research is needed to explore the best ways to measure the clinical effectiveness of GPSMI and to assess its cost-effectiveness in managing these common musculoskeletal conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effectiveness of physiotherapist-delivered group education and exercise interventions to promote self-management for people with osteoarthritis and chronic low back pain: a rapid review part I. Toomey, E., Currie-Murphy, L., Matthews, J., et al.[2022]

Physical therapists must effectively track outcomes for patients with low back pain to monitor treatment effectiveness, and this article reviews various measurement tools to aid in that process.

The article discusses the reliability and validity of common outcome measures, such as the SF-36 and Oswestry Questionnaire, providing practical guidelines for their selection and use in clinical practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Guide to outcomes measurement for patients with low back pain syndromes. Resnik, L., Dobrzykowski, E.[2019]

Physical therapy, whether delivered individually or in small groups, significantly improves pain, physical function, and health-related quality of life in patients with knee osteoarthritis, as shown in a study of 126 patients over 8 weeks.

Both treatment formats led to measurable improvements in knee strength and walking speed, with no significant differences in effectiveness between the two methods, indicating that either approach is beneficial for managing knee OA.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physical therapy is effective for patients with osteoarthritis of the knee: a randomized controlled clinical trial. Fransen, M., Crosbie, J., Edmonds, J.[2016]

In a case series of seven patients with mild-to-moderate hip osteoarthritis, the addition of body weight supported treadmill training (BWSTT) to standard physical therapy resulted in significant reductions in pain (average NPRS improvement of 2.9 points) and disability (WOMAC improvement of 18.5 points).

Despite improvements in pain and function, the study found that these changes did not lead to significant short-term enhancements in gait endurance, as measured by the 6-minute walk test, which increased by an average of 60.5 meters.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The addition of body weight supported treadmill training to manual therapy and exercise in the management of Hip osteoarthritis: A case series. Garcia, WJ., Sorensen, M., Diana, LT., et al.[2022]

A 12-month trial will compare two implementation support packages for a Group Physical Therapy Program aimed at treating knee osteoarthritis, with the goal of improving patient outcomes like pain and function while requiring fewer clinician hours.

This study is the first to assess the effectiveness of tailored, high-touch support versus standard low-touch support in implementing Group PT, which has shown promise in enhancing treatment delivery for knee OA patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Group physical therapy for knee osteoarthritis: protocol for a hybrid type III effectiveness-implementation trial. Webb, S., Drake, C., Coffman, CJ., et al.[2023]

The Group Physical Therapy (PT) program for knee osteoarthritis showed clinically relevant improvements in pain and function, with WOMAC scores decreasing from 56.8 to 46.9 and chair rise test performance increasing from 10.4 to 11.9 rises in 30 seconds among participants who completed the program.

Despite these positive outcomes, attendance and completion rates were lower than ideal, indicating a need for program adaptations to enhance participation and effectiveness in future implementations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Implementation of a group physical therapy program for Veterans with knee osteoarthritis. Allen, KD., Sheets, B., Bongiorni, D., et al.[2020]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10571277/

Group physical therapy for knee osteoarthritis The Group PT program has strong potential to become a standard offering for PT, improving function and pain-related outcomes for patients with ...

2. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2839540

Implementation of Group Physical Therapy for Knee ... For the fidelity outcome (as well as effectiveness outcomes), we included data from classes that occurred up to 15 months after the cohort start ...

3. withpower.com withpower.com/trial/phase-osteoarthritis-10-2018-909fd

Group Physical Therapy Classes for Osteoarthritis Pain The primary objective of this study is to study how low-impact group exercise classes affect pain scores in patients with knee, hip, and ankle pain when ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12492051/

Implementation of Group Physical Therapy for Knee ... Group-based physical therapy (PT) for knee osteoarthritis is an effective, efficient strategy for delivering care, but little is known about ...

5. clinicaltrials.gov clinicaltrials.gov/study/NCT07215572

Implementing a Group Physical Therapy Program for ... The Group PT sessions includes 6 sessions that include exercise and educational content. Patients will be eligible for Group PT if they have a ...

6. clinicaltrials.gov clinicaltrials.gov/study/NCT04980300

Delaware Physical Exercise and Activity for Knee ... The objective of this project is to examine the efficacy of an innovative Telehealth Physical Therapy (PT) program for adults with knee osteoarthritis (OA)

7. sciencedirect.com sciencedirect.com/science/article/pii/S1746068925000434

A RANDOMIZED CLINICAL CONTROL TRIAL It is a randomized, double-blinded controlled study design conducted at government hospitals for the period of 12 months.