The Effect Of Pain Neuroscience Education And Blended Exercises On Pain, Functional And Psychological Factors In Knee Oa: A Single-blind RCT

OBJECTIVE: The purpose of this study is to investigate the effect of pain neuroscience education (PNE) in combination with blended exercises (B-Exe) including aerobic, resistance, breathing, balance, and functional exercises, along with exercises booster sessions (EBS) on pain, functional and psychological factors in knee osteoarthritis (KOA). METHODS: In this RCT, 129 patients with KOA were randomly assigned to one of the B-Exe, PNE, the combination of PNE + B-Exe, and a control group. The primary outcomes were VAS and WOMAC. Secondary outcomes include the Pain Self-Efficacy Questionnaire, Depression, Anxiety and Stress Scale, Tampa Scale for Kinesiophobia, Short Falls Efficacy Scale International, Pain Catastrophising Scale, Short Form Health Survey (SF-12) and Exercise Adherence Rating Scale (EARS), 30-second chair sit-to-stand test, Timed Up and Go, lower limbs’ muscle strength and lower limb joints’ active range of motion were performed at baseline, 3 and 6 months. RESULTS: In the inter-group findings, the outcome improvement was significant (P ≤ 0.05) for the PNE + B-Exe, B-Exe, and PNE groups. The inter-group comparison of the first and second post-tests showed that the B-Exe and PNE + B-Exe groups had improvement (P ≤ 0.05) or lasting effects in all outcomes. In the intra-group findings, significant differences were observed between the PNE + B-Exe and the PNE and control groups in all outcomes (P ≤ 0.05). At the end of the study, there was a significant difference in EARS results between the B-Exe and PNE + B-Exe groups (P ≤ 0.05). CONCLUSION: We found that the B-Exe and PNE + B-Exe groups significantly affected pain, psychological, and functional factors in KOA. Supported by: Tehran University of Medical Sciences, Grant number: 401-02