About the research area
The goal of this research is to explore a range of best practice interventions to help a person living with knee osteoarthritis (OA) to manage their symptoms, especially early in the disease process. We recognise that people may want to have greater choice and knowledge about how best to manage their OA. Finding treatments that are effective for dealing with acute flare-ups, plus strategies for long-term management that fit with their life circumstances, are both important.
A focus of this work is to support early interventions for knee OA. It is imperative to find effective treatment options for early management of people with knee OA, thereby decreasing pain and disability, and potentially reducing later demand for costly joint replacement.
Previous research and clinical practice
Programme lead, Dr Cathy Chapple, is an experienced Musculoskeletal Physiotherapist. Cathy started her research career following many years in clinical practice in both the private and public sector.
Previous research has included the physiotherapy management of hip and knee OA (MOA trial), the incremental effects of manual therapy and booster sessions in addition to exercise for people with knee OA, and pre-habilitation for people with hip OA. Cathy completed her PhD as part of the MOA trial.
- Chapple, C. M., Nicholson, H., Baxter, G. D., & Abbott, J. H. (2011). Patient characteristics that predict progression of knee osteoarthritis: A systematic review of prognostic studies. Arthritis Care & Research, 63(8), 1115-1125. doi: 10.1002/acr.20492
- Abbott, J., Wilson, R., Pinto, D., Chapple, C., Wright, A., & Team, M. T. (2019). Incremental clinical effectiveness and cost effectiveness of providing supervised physiotherapy in addition to usual medical care in patients with osteoarthritis of the hip or knee: 2-year results of the MOA randomised controlled trial. Osteoarthritis and Cartilage, 27(3), 424-434.
Cathy was instrumental in translating research findings into practice with the team who developed, implemented and evaluated “The Joint Clinic” – a physiotherapy-led service in a New Zealand hospital for people with hip and knee OA.
- Abbott, J. H., Ward, A. L., Crane, C., Chapple, C. M., Stout, K., Hutton, L., … Harcombe, H., Ribeiro, D. C., & Gwynne Jones, D. (2019). Implementation of a 'Joint Clinic' to resolve unmet need for orthopaedic services in patients with hip and knee osteoarthritis: A program evaluation. BMC Musculoskeletal Disorders, 20(1), 324. doi: 10.1186/s12891-019-2702-1
Research study areas
The OPTI-OK Clinical Trial Optimal frequency of manual therapy for knee OA
The main aim of the Opti-OK randomised controlled trial (RCT) is to identify optimal frequency of manual therapy treatment for people with knee osteoarthritis. While there is growing evidence about the effectiveness of manual therapy for managing knee osteoarthritis, many aspects of dose have yet to be determined, including the frequency of treatment. In the absence of a scientific rationale, such decisions may be based upon convention, convenience, or cost considerations.
The trial has now finished. Keep an eye on this page for results.
Funding:
This clinical trial was funded by a Stanley Paris Fellowship.
A University of Otago Research Grant supported a feasibility trial, prior to the fully powered RCT.
Chapple, C. M., Abbott, J. H., & Tumilty, S. (2018). How does frequency of manual therapy influence outcome for people with knee osteoarthritis? A feasibility study. Osteoarthritis &Cartilage, 26(Suppl. 1), (pp. S339-S340). doi: 10.1016/j.joca.2018.02.673
The AP-KO Trial: Anti-inflammatories and physiotherapy for people with knee osteoarthritis
Oral anti-inflammatory medication and physiotherapy are proven treatments for people with knee OA, but the effect of combining them is unknown. We will evaluate clinical and cost-effectiveness of adding anti-inflammatories to best practice physiotherapy, compared with physiotherapy alone in a future RCT. Study recruitment for the feasibility trial (funded by the Health Research Council of New Zealand) will start in late 2023.
Study impact: Study findings will inform physiotherapists, pharmacists, doctors, and patients about the best way to use physiotherapy and anti-inflammatories for long-term management of knee OA.
The team: This team is a collaboration between physiotherapists, pharmacists, and physicians to provide good care and support. Dr Cathy Chapple, Daniel O'Brien, Mr David Cox, Professor Carlo Marra, Associate Professor Simon Stebbings, Dr Sharon Leitch, Dr Ari Samaranayaka
Funding:
Health Research Council of New Zealand Feasibility Funding.
Investigating exergaming as an intervention for people with knee OA
Knee OA is a long-term condition and as such requires patients to fully engage in self-management strategies, with exercise recognised as an essential and effective approach. To help promote this long-term engagement, we investigated the use of exergaming, using qualitative research methods to explore participants perceptions and enjoyment of the intervention.
The team: This research supported the PhD of Dr Donald Manlapaz.
- Manlapaz, D. G., Sole, G., Jayakaran, P., & Chapple, C. M. (2019). Risk factors for falls in adults with knee osteoarthritis: A systematic review. PM&R, 11, 745-757. doi: 10.1002/pmrj.12066
- Manlapaz, D. G., Sole, G., Jayakaran, P., & Chapple, C. M. (2022). Exergaming to improve balance and decrease the risk of falling in adults with knee osteoarthritis: a mixed-methods feasibility study. Physiotherapy theory and practice, 38(13), 2428-2440.
Funding:
Arthritis New Zealand Grant
Contact
Dr Cathy Chapple cathy.chapple@otago.ac.nz