Evaluating the efficacy of Internet-Based Exercise programme Aimed at Treating knee Osteoarthritis (iBEAT-OA) in the community: a study protocol for a randomised controlled trial

Gohir, Sameer Akram; Greenhaff, Paul L.; Abhishek, Abhishek; Valdes, Ana

doi:10.1136/bmjopen-2019-030564

Cited by 11 publications

(10 citation statements)

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“…The Internet-Based Exercise Programme Aimed at Treating Knee Osteoarthritis (iBEAT-OA) is a parallel-group randomized clinical trial, performed in the primary care setting and managed from Nottingham City Hospital, Nottingham, United Kingdom, in participants with knee osteoarthritis, JAMA Network Open | Orthopedics comparing a digitally delivered intervention with usual care self-management randomized in a 1-to-1 ratio. The trial protocol has been published elsewhere 13 and can be found in Supplement 2.…”

Section: Trial Designmentioning

confidence: 99%

Effectiveness of Internet-Based Exercises Aimed at Treating Knee Osteoarthritis

et al. 2021

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IMPORTANCE Osteoarthritis is a prevalent, debilitating, and costly chronic disease for which recommended first-line treatment is underused.OBJECTIVE To compare the effect of an internet-based treatment for knee osteoarthritis vs routine self-management (ie, usual care). DESIGN, SETTING, AND PARTICIPANTSThis randomized clinical trial was conducted from October 2018 to March 2020. Participants included individuals aged 45 years or older with a diagnosis of knee osteoarthritis recruited from an existing primary care database or from social media advertisements were invited. Data were analyzed April to July 2020. INTERVENTIONSThe intervention and control group conformed to first-line knee osteoarthritis treatment. For the intervention group, treatment was delivered via a smartphone application. The control group received routine self-management care. MAIN OUTCOMES AND MEASURESThe primary outcome was change from baseline to 6 weeks in self-reported pain during the last 7 days, reported on a numerical rating scale (NRS; range, 0-10, with 0 indicating no pain and 10, worst pain imaginable), compared between groups. Secondary outcomes included 2 physical functioning scores, hamstring and quadriceps muscle strength, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and quantitative sensory testing. RESULTS Among a total of 551 participants screened for eligibility, 146 were randomized and 105 were analyzed (mean [SD] age, 66.7 [9.2] years, 71 [67.1%] women), including 48 participants in the intervention group and 57 participants in the control group. There were no significant differences in baseline characteristics between the groups. At the 6-week follow-up, the intervention group showed a greater NRS pain score reduction than the control group (between-group difference, −1.5 [95% CI, −2.2 to −0.8]; P < .001). Similarly, the intervention group had better improvements in the 30-second sit-to-stand test (between-group difference, 3.4 [95% CI, 2.2 to 4.5]; P < .001) and Timed Up-and-Go test (between-group difference, −1.8 [95% CI, −3.0 to −0.5] seconds; P = .007), as well as the WOMAC subscales for pain (between-group difference, −1.1 [95% CI, −2.0 to −0.2]; P = .02), stiffness (between-group difference, −1.0 [95% CI, −1.5 to −0.5]; P < .001), and physical function (between-group difference, −3.4 [95% CI, −6.2 to −0.7]; P = .02). The magnitude of within-group changes in pain (d = 0.83) and function outcomes (30 second sit-to-stand test d = 1.24; Timed Up-and-Go test d = 0.76) in the intervention group corresponded to medium to very strong effects.No adverse events were reported. CONCLUSIONS AND RELEVANCEThese findings suggest that this internet-delivered, evidencebased, first-line osteoarthritis treatment was superior to routine self-managed usual care and could (continued) Key Points Question What is the effectiveness of an internet-based exercise program vs routine self-management on pain outcomes among patients with knee osteoarthritis? Findings This randomized clinical trial including 105 patie...

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Section: Trial Designmentioning

confidence: 99%

Effectiveness of Internet-Based Exercises Aimed at Treating Knee Osteoarthritis

et al. 2021

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“…The cohorts included a subset of the KPIC cohort (n = 129), 92 participants from the iBEAT-OA cohort, and a third cohort with 62 participants (Supplementary Table 1). Baseline pain data from the iBEAT-OA cohort (25) used in this study included quantitative sensory testing measurement of PPTs, temporal summation, and conditioned pain modulation. In the third cohort of 62 individuals with radiographic knee OA (24), participants were asked if they were currently experiencing knee pain at the time of blood donation, and pain was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (26).…”

Section: Methodsmentioning

confidence: 99%

Clinical and Preclinical Evidence for Roles of Soluble Epoxide Hydrolase in Osteoarthritis Knee Pain

Gowler

Turnbull

Shahtaheri

et al. 2022

Arthritis & Rheumatology

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Objective Chronic pain due to osteoarthritis (OA) is a major clinical problem, and existing analgesics often have limited beneficial effects and/or adverse effects, necessitating the development of novel therapies. Epoxyeicosatrienoic acids (EETs) are endogenous antiinflammatory mediators, rapidly metabolized by soluble epoxide hydrolase (EH) to dihydroxyeicosatrienoic acids (DHETs). We undertook this study to assess whether soluble EH–driven metabolism of EETs to DHETs plays a critical role in chronic joint pain associated with OA and provides a new target for treatment. Methods Potential associations of chronic knee pain with single‐nucleotide polymorphisms (SNPs) in the gene‐encoding soluble EH and with circulating levels of EETs and DHETs were investigated in human subjects. A surgically induced murine model of OA was used to determine the effects of both acute and chronic selective inhibition of soluble EH by N‐[1‐(1‐oxopropy)‐4‐piperidinyl]‐N′‐(trifluoromethoxy)phenyl]‐urea (TPPU) on weight‐bearing asymmetry, hind paw withdrawal thresholds, joint histology, and circulating concentrations of EETs and DHETs. Results In human subjects with chronic knee pain, 3 pain measures were associated with SNPs of the soluble EH gene EPHX2, and in 2 separate cohorts of subjects, circulating levels of EETs and DHETs were also associated with 3 pain measures. In the murine OA model, systemic administration of TPPU both acutely and chronically reversed established pain behaviors and decreased circulating levels of 8,9‐DHET and 14,15‐DHET. EET levels were unchanged by TPPU administration. Conclusion Our novel findings support a role of soluble EH in OA pain and suggest that inhibition of soluble EH and protection of endogenous EETs from catabolism represents a potential new therapeutic target for OA pain.

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“…Baseline serum samples from the Internet-Based Exercise Programme Aimed at Treating Knee Osteoarthritis (iBEAT-OA) cohort study (n = 94) were used as age-and sex-matched SARS-CoV-2-negative controls [31]. As these samples were collected prepandemic, a lack of SARS-CoV-2 infection was not confirmed.…”

Section: Sample Collection and Preparationmentioning

confidence: 99%

Serum Levels of Proinflammatory Lipid Mediators and Specialized Proresolving Molecules Are Increased in Patients With Severe Acute Respiratory Syndrome Coronavirus 2 and Correlate With Markers of the Adaptive Immune Response

Turnbull

Jha

Ortori

et al. 2022

The Journal of Infectious Diseases

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Background Specialised pro-resolution molecules (SPMs) halt the transition to chronic pathogenic inflammation. We aimed to quantify serum levels of pro- and anti-inflammatory bioactive lipids in SARS-CoV-2 patients, and to identify potential relationships with innate responses and clinical outcome. Methods Serum from 50 hospital admitted inpatients (22 female, 28 male) with confirmed symptomatic SARS-CoV-2 infection and 94 age and sex matched cohort collected prior to the pandemic (SARS-CoV-2 negative), were processed for quantification of bioactive lipids and anti-nucleocapsid and anti-spike quantitative binding assays. Results SARS-CoV-2 serum had significantly higher concentrations of omega-6 derived pro-inflammatory lipids and omega-6 and omega-3 derived SPMs, compared to age and sex matched SARS-CoV-2 negative group, which were not markedly altered by age or sex. There were significant positive correlations between SPMs, pro-inflammatory bioactive lipids and anti-spike antibody binding. Levels of some SPMs were significantly higher in patients with an anti-spike antibody value >0.5. Levels of linoleic acid (LA) and 5,6-dihydroxy-8Z,11Z,14Z-eicosatrienoic acid (5,6-DHET) were significantly lower in SARS-COV-2 patients who died. Discussion SARS-COV-2 infection was associated with increased levels of specialised pro-resolution molecules and other pro- and anti-inflammatory bioactive lipids, supporting the future investigation of the underlying enzymatic pathways, which may inform the development of novel treatments.

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Evaluating the efficacy of Internet-Based Exercise programme Aimed at Treating knee Osteoarthritis (iBEAT-OA) in the community: a study protocol for a randomised controlled trial

Cited by 11 publications

References 95 publications

Effectiveness of Internet-Based Exercises Aimed at Treating Knee Osteoarthritis

Effectiveness of Internet-Based Exercises Aimed at Treating Knee Osteoarthritis

Clinical and Preclinical Evidence for Roles of Soluble Epoxide Hydrolase in Osteoarthritis Knee Pain

Serum Levels of Proinflammatory Lipid Mediators and Specialized Proresolving Molecules Are Increased in Patients With Severe Acute Respiratory Syndrome Coronavirus 2 and Correlate With Markers of the Adaptive Immune Response

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