Pain informed movement compared to neuromuscular exercise and standard education in people with knee osteoarthritis: A pilot and feasibility randomized controlled trial
Bibliographic record
Abstract
Objective: To determine the feasibility of conducting a full-scale randomized controlled trial to test the effectiveness of pain informed movement (PIM) (includes mind-body techniques, neuromuscular strengthening exercises (NEMEX) and pain neuroscience education), compared to NEMEX and standard education in people with knee osteoarthritis (KOA). Methods: Adults ≥40 years with KOA were randomized to a twice weekly in-person group program for 8 weeks. Education was delivered through weekly videos. Recruitment, follow-up, adherence (attendance), compliance to home exercises, burden of procedures as well as patient-reported clinical outcomes, quantitative sensory tests, the sit to stand test, and serum levels of brain derived neurotrophic factor and nerve growth factor were assessed before and immediately after treatment. Focus groups were conducted post intervention. Results: 210 people were screened for eligibility. 69 (33 %) were randomized and 59 (28 PIM, 31 NEMEX; 86 %) completed the trial. The primary outcome of follow up rate was met along with all other a priori criteria. There was high acceptability of both interventions (≥86 %), and perceived low burden of procedures (≥80 %). Only minor adverse events were reported. Secondary outcomes improved across most clinical measures in both groups with the PIM group showing clinically important improvement in pain. Focus group feedback suggests the need to consider an alternative format to video delivery of the education content. Conclusion: This pilot RCT indicates that a full trial is feasible and warranted to test the effectiveness of PIM versus NEMEX and standard education with the potential to provide mechanistic insights based on nervous system modulation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.008 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.012 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".