A pilot randomised controlled trial of an online self-management programme for people with persistent pain post-knee replacement (Kneed).
Nathan Johns, Dean McKenzie, Bernadette Brady and 2 others
PMID 40990623WHAT IT FOUND
An online pain self-management programme was feasible but saw high dropout in the first four weeks.
Among those who finished, half reported a 50% pain reduction compared to 18% in usual care, though the study was too small to confirm this benefit.
Key findings
01Recruitment was feasible via social media, but 35.5% of the intervention group withdrew before completing the introductory module, often due to technology issues or lack of time.
02Participants who remained in the trial rated the programme as acceptable and useful, with a mean satisfaction score of 5.8 out of 7.
03At 8 weeks, 50% of the intervention group reported a 50% or greater reduction in pain compared to 18% of the usual care group, but no statistical significance testing was performed.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was a pilot designed for feasibility, so it was underpowered to detect clinical effects and did not perform statistical significance tests on outcomes. There was a high dropout rate in the intervention group (35.5%), which introduces attrition bias and means the positive results only apply to those who stuck with the programme. Baseline characteristics differed between groups despite randomisation, with the usual care group being older and more female, which could influence outcomes. The programme was unsupervised, which may explain the high early withdrawal rates compared to supported digital interventions. Generalisability is limited to Australian adults with osteoarthritis who had reliable internet access and English literacy.
Declared interests
One author (Dr Nathan Johns) developed the Kneed programme as part of his PhD and is the sole owner of its copyright. Funding came from the Epworth Monash Rehabilitation Research Unit and Peninsula Health Department of Rehabilitation.
The easy way to misread this
Do not interpret the 50% responder rate in the Kneed group as proof of efficacy. This was a small pilot with high dropout, and the analysis did not test for statistical significance. The results only show that the programme was acceptable to those who managed to complete it.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →