PTOTRCTArchives of physical medicine and rehabilitation2017

Mindfulness Is Associated With Treatment Response From Nonpharmacologic Exercise Interventions in Knee Osteoarthritis.

Augustine C Lee, William F Harvey, Lori Lyn Price and 6 others

PMID 28506776

WHAT IT FOUND

Patients with higher baseline mindfulness were 38% more likely to respond to Tai Chi or physical therapy for knee osteoarthritis.

The specific facet of acting with awareness showed the strongest association with treatment success.

Key findings

01Participants with higher total mindfulness were 38% more likely to respond to treatment than those with lower mindfulness.

02Among the five mindfulness facets, acting with awareness showed the greatest effect, with medium levels being 46% more likely to respond than lower levels.

03The study was a secondary analysis of a trial comparing Tai Chi and Physical Therapy, combining data from both groups to analyze predictors of response.

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

This is a secondary analysis, not a trial designed to test mindfulness as a primary predictor. The sample size was small (86 analyzed out of 204 recruited), limiting statistical power. The study combined Tai Chi and Physical Therapy groups, so it cannot determine if mindfulness predicts response differently for one treatment versus the other. There was no control group, so the study cannot distinguish true treatment effects from placebo or regression to the mean. The mindfulness sample was skewed towards higher scores and may not represent the general population of patients with knee osteoarthritis.

Declared interests

JBW has research funding from PCORI for a study on total knee replacement. The remaining authors reported no conflicts of interest. The study was funded by the National Institutes of Health.

The easy way to misread this

Do not interpret this as evidence that prescribing mindfulness training will improve physical therapy outcomes. The study only shows that patients who already have higher mindfulness scores were more likely to respond to the exercise interventions, but it does not prove causation or that increasing mindfulness would change the result.

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