Combining goal setting and achievement with occupational therapy to improve pain, psychological factors and physical activity in patients after high tibial osteotomy: A non-randomized controlled study.

Patients were allocated by treatment period rather than random assignment, so unmeasured differences between groups may explain the results. The paper reports different group sizes in the methods and results sections, so the analysed sample is unclear. The study analysed only 14 intervention and 17 control patients, so findings are uncertain. The results text reports physical activity time in minutes, while the table labels the same values as seconds. Follow-up was only until hospital discharge at about five weeks, so long-term effects are unknown. All patients also received surgery, non-steroidal anti-inflammatory drugs and physical therapy, and the intervention group received occupational therapy, so the contribution of any single component cannot be separated. The paper does not state a single primary outcome, and several outcomes were analysed. Patients with dementia, obvious mental illness, refusal of occupational therapy, postoperative complications, significant medical conditions, prior high tibial osteotomy or non-degenerative causes were excluded, so results may not apply to those groups. The control group did not receive occupational therapy, so the intervention group had additional therapist contact, which may have influenced outcomes.

Do not conclude that goal setting alone caused the improvements. Walking pain did not differ between groups. All patients also received surgery, non-steroidal anti-inflammatory drugs and physical therapy, and the intervention group received occupational therapy, so the contribution of any single component cannot be separated.