title: Effectiveness of a cognitive-behavioural group intervention for knee osteoarthritis pain: a randomized controlled trial.
abstract: OBJECTIVE
  To assess the effectiveness of a six week cognitive-behavioural group intervention in patients with knee osteoarthritis pain.
  
  
  METHODS
  Single-blinded randomized controlled trial.
  
  
  METHODS
  Primary care providers in a medium-sized city in Finland.
  
  
  METHODS
  A total of 111 participants aged from 35 to 75 with clinical symptoms and radiographic grading (Kellgren-Lawrence 2-4) of knee osteoarthritis were included.
  
  
  METHODS
  In the intervention group, 55 participants attended a cognitive-behavioural training programme for pain management with six weekly group sessions supervised by a psychologist and a physiotherapist. Concurrently, they and the 56 participants of the control group continued in ordinary GP care that was not altered by the study.
  
  
  METHODS
  The primary outcome on three-month and 12-month follow-up was the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis index pain subscale. Secondary outcome measures included self-reports of pain and physical function, health-related quality of life, and a comprehensive set of psychological questionnaires.
  
  
  RESULTS
  Mixed model results showed no significant differences between the intervention and control group for any measures of pain or function. A significant difference between the groups was found in the Pain Self-Efficacy Questionnaire (Pr = 0.022) in favour of the control group, and in the RAND-36 emotional well-being subscale in favour of the intervention group (Pr = 0.038). Conventional group comparisons of mean follow-up values showed no significant differences in any of the outcome variables.
  
  
  CONCLUSIONS
  This trial could not confirm the hypothesized advantage of a cognitive-behavioural training programme over ordinary GP care in knee osteoarthritis pain patients.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN64794760.
authors.affiliation: Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Kuopio, Finland Psychiatry, City of Helsinki Health Centre, Helsinki, Finland eeva-eerika.helminen@fimnet.fi.
authors.forename: Eeva-Eerika
authors.initials: EE
authors.lastname: Helminen
authors.affiliation: Institution of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
authors.forename: Sanna H
authors.initials: SH
authors.lastname: Sinikallio
authors.affiliation: Department of Psychiatry, Addiction Psychiatry Outpatient Clinic, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Anna L
authors.initials: AL
authors.lastname: Valjakka
authors.affiliation: Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Rauni H
authors.initials: RH
authors.lastname: Väisänen-Rouvali
authors.affiliation: Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Kuopio, Finland Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Jari P A
authors.initials: JP
authors.lastname: Arokoski
mesh_terms: D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications* / Q000523:psychology / Q000628:therapy*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D011615:Psychotherapy, Group; D011788:Quality of Life; D016037:Single-Blind Method; D016896:Treatment Outcome
keywords: Osteoarthritis; cognitive–behavioural; intervention study; pain management; psychological