Physical Therapy for Osteoarthritis
(TeMPO Trial)
What You Need to Know Before You Apply
What is the purpose of this trial?
Knee osteoarthritis is a disabling problem affecting over 15 million adults in the United States. Many people who have knee arthritis also experience painful meniscal tears. There are a number of different treatments that can be used to manage meniscal tears in the presence of knee arthritis. Treatments include surgically removing the damaged part of the meniscus; strengthening exercises to improve pain and function; manual therapy including massage and mobilization; acupuncture; and others. The combination of surgery and exercise therapy was long thought to be the best treatment. However, recent studies have shown that surgery followed by physical therapy is no more effective than physical therapy by itself.While physical therapy alone has been shown to result in similar pain relief as arthroscopic surgery, researchers have not yet done studies to determine what type of physical therapy is best for people with knee arthritis and meniscal tears. In the "TeMPO" Trial, we will be comparing 4 different, non-operative physical therapy regimens in order to gain a better understanding of how physical therapy works and what regimen will best reduce pain and improve function in persons with meniscal tear and osteoarthritis. The four arms in this randomized trial will contain different combinations of therapeutic treatments including in-clinic therapist-supervised exercise, in-clinic topical therapies, and exercises to be completed at home. Subjects in three of the arms will also receive motivational SMS (text) messages intended to improve adherence to the home exercise regimen.TeMPO is designed as a randomized controlled trial. Participants will be assigned randomly to one of the four arms. All arms include therapies that have been previously shown to work in clinical settings. One arm also contains some placebo treatments. The placebo treatments will help us to understand what aspects of physical therapy actually make people feel better.Our hypothesis is that subjects in the arm that includes in-clinic physical therapy and a home exercise regimen will experience more pain relief than subjects in each of the other arms. Also, we expect that subjects in the arm that receives the home exercise regimen and SMS messages will experience more pain relief than subjects in the arm that receives home exercise without the SMS messages.
Will I have to stop taking my current medications?
The trial protocol does not specify whether you need to stop taking your current medications. However, if you are using strong opioids daily or have had intra-articular therapy in the last 4 weeks, you may not be eligible to participate.
Is physical therapy for osteoarthritis safe?
Topical treatments for osteoarthritis, like topical NSAIDs, are generally considered safe, especially for older adults, as they have fewer risks compared to oral NSAIDs. Exercise programs, when supervised and cleared by a doctor, are also safe for elderly individuals, even those with limited mobility or chronic illnesses.12345
How is the TeMPO Home Exercise Program treatment different from other treatments for osteoarthritis?
The TeMPO Home Exercise Program is unique because it allows patients to perform physical therapy exercises at home, which can be more convenient and cost-effective compared to traditional office-based physical therapy sessions. This approach is particularly beneficial for older adults or those living in remote areas, as it reduces the need for travel and professional supervision while still being as effective as in-person therapy.678910
What data supports the effectiveness of this treatment for osteoarthritis?
Who Is on the Research Team?
Chuck Washabaugh, PhD
Principal Investigator
National Institute for Arthritis, Musculoskeletal and Skin Diseases (NIAMS, NIH)
Are You a Good Fit for This Trial?
This trial is for adults aged 45-85 with knee pain from a meniscal tear and osteoarthritis, confirmed by MRI or X-ray. Candidates must have had knee pain for at least 21 days if it's due to injury. Exclusions include inflammatory arthritis, recent knee surgery, pregnancy, MRI contraindications, strong opioid use, recent joint therapy, nursing home residents, dementia history or worker's compensation claimants.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants are assigned to one of four physical therapy regimens, including home exercises, SMS messages, in-clinic topical therapy, and in-clinic exercise therapy
Follow-up
Participants are monitored for changes in pain, function, and quality of life
Long-term Follow-up
Participants are monitored for durability of pain relief and treatment outcomes
What Are the Treatments Tested in This Trial?
Interventions
- In-Clinic Exercise Therapy
- In-Clinic Topical Therapy
- Motivational SMS Messages
- TeMPO Home Exercise Program
Find a Clinic Near You
Who Is Running the Clinical Trial?
Brigham and Women's Hospital
Lead Sponsor
State University of New York at Buffalo
Collaborator
National Institutes of Health (NIH)
Collaborator
Boston University
Collaborator
The Cleveland Clinic
Collaborator
University of Pittsburgh
Collaborator
University of Melbourne
Collaborator