Singapore KneE osTeoarthritis CoHort (SKETCH): protocol for a multi-centre prospective cohort study

Tan, Bien-Keem; Goh, Zack Zhong Sheng; Lim, Chien Joo; Pereira, Michelle Jessica; Yang, Su-Yin; Tan, Kelvin Guoping; Tan, Alvin Chin Kwong; Liang, Phyllis; Abbott, J. Haxby; Briggs, Andrew M.; Hunter, David J.; Skou, Søren Thorgaard; Thumboo, Julian; Car, Josip

doi:10.1186/s12891-023-06207-1

Cited by 10 publications

(3 citation statements)

References 68 publications

(86 reference statements)

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“…It reduces respondent burden by 70% from the original KOOS while providing scale scores for knee-specific pain, function, and QOL, along with a summary measure of overall knee impact [ 40 ]. The KOOS score has been validated in Singapore [ 39 , 41 ].…”

Section: Methodsmentioning

confidence: 99%

Heat and Acupuncture to Manage Osteoarthritis of the Knee (HARMOKnee): Protocol for an Effectiveness-Implementation Hybrid Randomized Controlled Trial

Tan,

Tan

et al. 2024

JMIR Res Protoc

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Background Knee osteoarthritis (KOA) is one of most prevalent and fastest-growing causes of pain, impaired mobility, and poor quality of life in the rapidly aging population worldwide. There is a lack of high-quality evidence on the efficacy of traditional Chinese medicine (TCM), particularly acupuncture, and a lack of KOA practice guidelines that are tailored to unique population demographics and tropical climates. Objective Our HARMOKnee (Heat and Acupuncture to Manage Osteoarthritis of the Knee) trial aims to address these gaps by evaluating the short- and medium-term clinical and cost-effectiveness of acupuncture with heat therapy in addition to standard care, compared to standard care alone. Through a robust process and economic evaluation, we aim to inform evidence-based practice for patients with KOA to facilitate the large-scale implementation of a comprehensive and holistic model of care that harmonizes elements of Western medicine and TCM. We hypothesize that acupuncture with heat therapy as an adjunct to standard care is clinically more effective than standard care alone. Methods A multicenter, pragmatic, parallel-arm, single-blinded, effectiveness-implementation hybrid randomized controlled trial will be conducted. We intend to recruit 100 patients with KOA randomized to either the control arm (standard care only) or intervention arm (acupuncture with heat therapy, in addition to standard care). The inclusion criteria are being a community ambulator and having primary KOA, excluding patients with secondary arthritis or previous knee replacements. The primary outcome measure is the Knee Osteoarthritis Outcome Score at 6 weeks. Secondary outcome measures include psychological, physical, quality of life, satisfaction, and global outcome measures at 6, 12, and 26 weeks. A mixed method approach through an embedded process evaluation will facilitate large-scale implementation. An economic evaluation will be performed to assess financial sustainability. Results Patient enrollment has been ongoing since August 2022. The recruitment process is anticipated to conclude by July 2024, and the findings will be analyzed and publicized as they are obtained. As of November 6, 2023, our patient enrollment stands at 65 individuals. Conclusions The findings of our HARMOKnee study will contribute substantial evidence to the current body of literature regarding the effectiveness of acupuncture treatment for KOA. Additionally, we aim to facilitate the creation of standardized national guidelines for evidence-based practice that are specifically tailored to our unique population demographics. Furthermore, we seek to promote the adoption and integration of acupuncture and heat therapy into existing treatment models. Trial Registration ClinicalTrials.gov NCT05507619; https://clinicaltrials.gov/study/NCT05507619 International Registered Report Identifier (IRRID) DERR1-10.2196/54352

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Section: Methodsmentioning

confidence: 99%

Heat and Acupuncture to Manage Osteoarthritis of the Knee (HARMOKnee): Protocol for an Effectiveness-Implementation Hybrid Randomized Controlled Trial

Tan,

Tan

et al. 2024

JMIR Res Protoc

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“…This study analyzed baseline data collected as part of a pre-registered (clinicaltrials.gov, NCT04942236 first registered 28/06/2021) multi-center, prospective cohort study for people with knee osteoarthritis in Singapore [ 24 ]. This study is reported following the STROBE guidelines [ 25 ].…”

Section: Methodsmentioning

confidence: 99%

A cross sectional study exploring the relationship of self-reported physical activity with function, kinesiophobia, self-efficacy and quality of life in an Asian population seeking care for knee osteoarthritis

Goff,

Jones,

Lim

et al. 2024

BMC Musculoskelet Disord

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Background Physical activity is a guideline-recommended first-line intervention for people with knee osteoarthritis. Physical activity levels, and its potential correlates, is underexplored in Asian populations with knee osteoarthritis. Methods Participants enrolled in a longitudinal study in Singapore self-reported physical activity (UCLA activity score), function (Knee Osteoarthritis Outcome Score [KOOS-12]), kinesiophobia (Brief fear of movement [BFOM]), self-efficacy (ASES-8), and quality of life (EQ-5D-5 L). One-Way ANOVA was used to test the difference in outcomes between UCLA categories, while ordinal logistic regression was used to identify the associated factors to physical activity level. Results Seventy-three percent of all enrolled participants (n = 311/425) reported either inactivity or low physical activity (median 4, IQR 3–5). Significant, weak, positive correlations were observed be-tween UCLA activity score and either KOOS-12 (Spearman’s rho: 0.1961; p < 0.001), ASES-8 (0.1983; p = 0.004), or EQ-5D-5 L (0.2078; p < 0.001). A significant, weak, negative correlation was observed between physical activity and BFOM (-0.2183; p < 0.001). Significant differences in function between groups (moderate vs. inactive or low physical activity) were not clinically important. Participants with obesity, from the eldest age category (i.e. ≥75), or who identified as Malay or female, were less physically active than those with a healthy BMI, below the age of 54, or who identified as Chinese or male, respectively. Conclusion Healthcare professionals in Asia should be aware of the large proportion of people with knee osteoarthritis who are either inactive or have low physical activity levels. Screening for, and offering interventions to promote, physical activity and its correlates should be prioritised.

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“…Existing large, international cohort studies focus primarily on biological factors such as radiographic imaging and biomarkers [13, 16]. Recent efforts have started to lay the groundwork for large longitudinal cohorts focusing on psychosocial factors [18].…”

Section: How Do We Get There?mentioning

confidence: 99%

CORR Insights®: What Are the Underlying Mental Health Constructs Associated With Level of Capability in People With Knee and Hip Osteoarthritis?

Tan

2024

Clin Orthop Relat Res

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The author certifies that there are no funding or commercial associations (consultancies, stock ownership, equity interest, patent/ licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article related to the author or any immediate family members. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research ® editors and board members are on file with the publication and can be viewed on request. The opinions expressed are those of the writer, and do not reflect the opinion or policy of CORR ® or The Association of Bone and Joint Surgeons ® .

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Singapore KneE osTeoarthritis CoHort (SKETCH): protocol for a multi-centre prospective cohort study

Cited by 10 publications

References 68 publications

Heat and Acupuncture to Manage Osteoarthritis of the Knee (HARMOKnee): Protocol for an Effectiveness-Implementation Hybrid Randomized Controlled Trial

Heat and Acupuncture to Manage Osteoarthritis of the Knee (HARMOKnee): Protocol for an Effectiveness-Implementation Hybrid Randomized Controlled Trial

A cross sectional study exploring the relationship of self-reported physical activity with function, kinesiophobia, self-efficacy and quality of life in an Asian population seeking care for knee osteoarthritis

CORR Insights®: What Are the Underlying Mental Health Constructs Associated With Level of Capability in People With Knee and Hip Osteoarthritis?

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