A feasibility study of brain-targeted treatment for people with painful knee osteoarthritis in tertiary care

Anton Harms, Alberto M. Heredia-Rizo, G. Lorimer Moseley, Raphael Hau, Tasha R. Stanton

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)


Purpose: To assess the feasibility and clinical impact of brain-targeted treatment (BT; aiming to target sensorimotor processing) in knee osteoarthritis patients attending tertiary care. Methods: Randomized replicated case series. The study involved three phases, each of 2 weeks duration: (1) no-treatment phase; (2) BT phase (left/right judgments and touch discrimination training); and (3) usual care (education, strengthening, and stretching training). Primary outcomes were: timely recruitment; number of participants completing the interventions; treatment compliance and barriers; follow-up rates; and treatment impact on pain and function. Fear-avoidance beliefs and clinical measures of cortical body representation (tactile acuity and left/right judgment performance) were secondary outcomes. Results: A total of 5% (19/355) of all assessed patients were eligible to participate and of these, 58% (11/19) agreed to participate. Ten patients completed the study, and 9 were successfully followed up, with treatment compliance varying between interventions. Compliance was poor for the touch discrimination component of BT. No significant effects were observed for pain relief or knee function after any treatment. A positive impact of treatment was found for fear-avoidance beliefs (usual care vs. washout, p = 0.007; BT vs. washout, p = 0.029) and left/right judgment accuracy (usual care vs. washout; p = 0.006). Conclusions: Clear barriers were identified to implementing BT in tertiary care for knee osteoarthritis. Access to all available services (especially the use of interpreters), and treatment options that do not require additional assistance to perform (e.g., touch discrimination training) represent the main lessons learned.

Original languageEnglish
Pages (from-to)142-156
Number of pages15
JournalPhysiotherapy Theory and Practice
Issue number1
Publication statusPublished or Issued - 2 Jan 2020
Externally publishedYes


  • Feasibility study
  • motor imagery
  • osteoarthritis
  • patient compliance
  • tactile discrimination training
  • usual care

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this