CClinicalTrials.gg
CompletedNCT05524116TEMPOUpdated Jan 16, 2025Results posted

Telehealth Exercise and Mindfulness for Pain in Osteoarthritis

An interventional study of Mindful Exercise program and Exercise in Knee Osteoarthritis, sponsored by Boston University Charles River Campus. Completed at 1 site in United States. Open to participants aged 50 Years and older. Per ClinicalTrials.gov, last updated 2025-01-16.

Sponsored by Boston University Charles River Campus · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
45
Allocation
Randomized
Ages
50 Years and older
Sex
All
01

Study summary

This is a parallel-arm mixed-methods randomized controlled trial to investigate the feasibility of telehealth delivered mindful exercise vs. usual exercise interventions for people with knee osteoarthritis.

Read the detailed description

In this RCT, the feasibility of an 8-week telehealth mindful exercise intervention compared to an 8-week telehealth exercise only intervention for people with knee osteoarthritis (OA) will be assessed. Forty adults with knee OA will be assigned to either a mindful exercise arm OR exercise arm. Both interventions will be delivered via real-time videoconferencing in a group setting (n=8-10 per group). All participants will be administered questionnaires for self-reported symptoms, mood, quality of life, etc. throughout the study period. Participants will be given the choice to opt in for in-person data collection visits wherein their physical function, muscle strength, sensitivity to painful stimuli, and brain function will be assessed before and at the end of the interventions. At the end of the 8-week interventions, 10 participants will be purposively sampled from each arm (n=20 total) for individual interviews to determine acceptability of the telehealth interventions. Feasibility of the intervention will be determined post-intervention by outcome measures such as recruitment rate, retention rate, and adherence.

02

Conditions studied

  • Knee Osteoarthritis

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Keywords

  • telehealth
  • exercise
  • mindfulness
  • pain
  • feasibility
03

In context

Osteoarthritis

4,398 studies on the registry are indexed under Osteoarthritis; 582 are open to participants now.

This study's enrollment of 45 is below the median of 70 across 3,440 interventional studies indexed under Osteoarthritis.

Browse Osteoarthritis studies →

Lead sponsor

Boston University Charles River Campus is the lead sponsor of 154 studies on the registry; 30 are open to participants now.

Of its 14 completed or terminated interventional studies of FDA-regulated products, 8 (57%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
50 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Meet National Institute for Health and Clinical Excellence clinical guidelines for knee osteoarthritis (i.e., age ≥ 50 years, presence of activity related pain, presence of morning knee stiffness ≤ 30 minutes)
  • BMI\<40
  • Knee pain on most days for 3 months or more
  • Average overall knee pain severity of ≥= 4 on a 11-point numeric rating scale during previous week
  • Able to attend remote sessions
  • Can speak and understand English at a sufficient level to understand the study procedures and informed consent.
  • Available for study duration

Exclusion criteria

Exclusion Criteria:

  • Contraindications to exercise
  • Other pain in lower back or legs that is greater than knee pain
  • Received physical therapy treatment for knee OA in the past 6 months or currently receiving physical therapy
  • Received any mindfulness programs such as Tai Chi, meditation, etc. in the past 6 months or currently receiving such program
  • Currently receiving chemotherapy or radiation therapy for cancer except non-melanoma skin cancer
  • History of other disease that may involve the index joint including inflammatory joint disease such as rheumatoid arthritis, seronegative spondyloarthropathy (eg, ankylosing spondylitis, psoriatic arthritis, inflammatory bowel disease related arthropathy), crystalline disease (eg, gout or pseudogout), lupus erythematosus, knee joint infections, Paget's disease affecting the knee, or knee joint tumors.
  • Any knee surgery in the previous 6 months
  • Joint replacement in either hip or ankle
  • Previous knee osteotomy partial or total knee replacement in either knee
  • Planned major treatment for knee OA (e.g., surgery, injections, physical therapy) during the study period
  • Planned major surgery in the next 6 months
  • Corticosteroid or hyaluronic acid injections in either knee in the previous 3 months
  • Neurological conditions that impacts motor functioning (e.g., stroke, Parkinson's disease, Alzheimer's disease, Multiple Sclerosis, diabetic neuropathy, etc).
  • Pregnancy (self-report)
  • Participation in another clinical trial for any joint or muscle pain
  • Suspected or known drugs or alcohol abuse
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
45 participants (actual)

Study arms

  • Active comparator
    Group TX (Telehealth Exercise)

    Participants in this group will receive a supervised and group-based exercise program once a week for 8 weeks via telehealth.

    Behavioral: Exercise

  • Experimental
    Group TMX (Telehealth Exercise and Mindfulness)

    Participants in this group will receive a supervised, group-based integrated mindfulness and exercise program once a week for 8 weeks via telehealth.

    Behavioral: Mindful Exercise program

Interventions

  • BehavioralMindful Exercise program

    In this 8-week intervention, components of Mindful Based Stress Reduction Program will be integrated with strengthening and neuromuscular exercises recommended for knee osteoarthritis. The goal of this program is to train participants how to be mindful during their exercises.

  • BehavioralExercise

    In this 8-week intervention, participants will be given recommended strengthening and neuromuscular exercises for knee osteoarthritis. Participants in both the intervention and control group will receive these exercises.

06

What researchers measure

Primary outcomes

  1. Recruitment

    Number of participants that are randomized for the study

    Time frame: through the recruitment process, up to 6 months from the start of the study

  2. Attendance

    Proportion of sessions attended

    Time frame: post-intervention (at 8-weeks)

  3. Retention Rate

    Proportion of participants who complete patient-reported outcome surveys

    Time frame: post-intervention visit (at the end of 8-weeks)

  4. Participant Feedback Survey

    Custom scale measuring feedback on interventionists and interventions. Scores range from 0-4 (0 - Strongly Disagree, 1 - Disagree, 2 - Neither Agree no Disagree, 3 - Agree, and 4 - Strongly Agree)

    Time frame: 8-week

  5. Satisfaction Scale

    Custom 4-item (0-10 scale) to determine satisfaction with individual components of the intervention (i.e.,, exercise, mindfulness, telehealth, and overall satisfaction). There are 4 items and each item is scored separately. Higher scores for each item mean greater satisfaction for that dimension.

    Time frame: 8-week

Secondary outcomes

  1. Knee Injury and Osteoarthritis Outcome Score

    Patient-reported outcome for knee pain and disability; a percentage score from 0 to 100, 0 representing extreme problems and 100 representing no problems.

    Time frame: baseline, 8-week, 14-week

  2. Pain, Enjoyment, General Activity Scale

    Assesses Pain Intensity and Interference. the response range is 0-10; the PEG scale score is the mean of the three individual item scores. Higher scores represent worse pain.

    Time frame: baseline, 8-week, 14-week

  3. Numeric Rating Scale - Nominated Activity

    average rating of knee pain from 0-10, where 0 represents no pain and 10 represents worst pain imaginable, in the past week in a nominated activity selected at baseline

    Time frame: baseline, 8-week, 14-week

  4. Participant Global Impression of Change

    participant's rating of change in condition on a 14-point scale ranging from "a very great deal worse" to "a very great deal better". Values range from -7 to +7 (excluding 0). Score \>=1 represent improvement and scores \<= -1 represent worsening.

    Time frame: 8-week, 14-week

  5. Patient Global Assessment of Osteoarthritis

    participant's assessment of impact of osteoarthritis on their general health on a 0-100 mm scale. higher scores represent higher impact of disease or worse global health

    Time frame: baseline, 8-week, 14-week

  6. Pain Catastrophizing Scale

    3-item scale which measures of catastrophizing related to pain. Each item is rated on a 5-point scale: 0 (Not at all) to 4 (all the time).

    Time frame: baseline, 8-week

  7. Widespread Pain Index Symptom Severity Scale

    self-report on severity of cognitive symptoms such as fatigue, trouble thinking or remembering, waking up tired, and other physical symptoms such as headache, dizziness, etc. Each symptom is scored on a 4-point scale where 0 indicates no problem and 3 indicates severe problem. Scores are calculated by summing items, with higher scores (out of a maximum score of 12) indicating greater symptom severity.

    Time frame: baseline, 8-week

  8. Pain DETECT

    self-report measure on presence of neuropathic pain. each question is scored from 0 to 5 where higher scores indicate higher gradation of pain. The final score is between -1 and 38 and a score of 19 and higher indicates higher likelihood of neuropathic pain

    Time frame: baseline, 8-week

  9. Patient Health Questionnaire 8-item

    8-item questionnaire assessing depression symptoms. Each question is scored from 0 to 3 where higher scores indicate higher frequency of experiencing depressive symptoms. Total score is the sum of individual item scores. Score range is 0-24. Higher total scores indicate greater severity of depression

    Time frame: baseline, 8-week, 14-week

  10. Cognitive and Affective Mindfulness Scale - Revised

    12-item scale on dispositional mindfulness. Items are rated on a 4-point Likert scale from 1 (rarely/not at all) to 4 (almost always). Scores on the scale are summed. Higher scores reflect greater mindfulness.

    Time frame: baseline, 8-week, 14-week

  11. Fear Avoidance Beliefs Questionnaire - Physical Activity

    4-item questionnaire to determine how one's fear avoidance beliefs contributes to the cognitive/affective part of their knee pain. Each item is scored from 0 to 6. Total scores are summation of each item scores. Range is 0-24. Higher total scores indicate greater fear of physical activity

    Time frame: baseline, 8-week

  12. Arthritis Self Efficacy Scale

    Questionnaire to assess confidence in one's capacity to function despite pain. Each item in the questionnaire is scored on a 1-10 scale. It provides three subscales of pain, function, and other symptoms calculated as average of items contributing to that subscale. Range for each subscale is 1-10. Higher scores indicate greater self-efficacy to manage osteoarthritis.

    Time frame: baseline, 8-week

  13. Chronic Pain Self-efficacy Questionnaire

    Measures three domains of pain self-efficacy: pain management, physical functioning, and coping with symptoms. Each item is scored on a scale of 0 (very uncertain) to 100 (very certain). Score for each domain is the average of all items contributing to that domain. Higher total scores indicate greater self-efficacy to manage one's chronic pain.

    Time frame: baseline, 8-week

Other outcomes

  1. Arthritis - Rapid Estimate of Adult Literacy in Medicine (A-REALM)

    66-word recognition adult health literacy test. Each correct pronunciation of word is scored as 1. The total score is classified into 1 to 4 reading grade levels where higher scores (61-66) represent ninth grade and above reading level

    Time frame: baseline

  2. Sit to Stand Test [OPTIONAL IN-PERSON VISIT]

    functional test that measures the time taken to sit and stand from chair five times

    Time frame: baseline, 8-week

  3. 6-minute Walk Test [OPTIONAL IN-PERSON VISIT]

    functional test that measures the maximal distance covered while walking at fast-pace for six minutes

    Time frame: baseline, 8-week

  4. 7-meter Walk Test [OPTIONAL IN-PERSON VISIT]

    functional test that measures comfortable walking speed as participant walks back and forth over 7 meters twice

    Time frame: baseline, 8-week

  5. Stair Climb Test [OPTIONAL IN-PERSON VISIT]

    functional test that measures the time taken to ascend and descend a flight of stairs

    Time frame: baseline, 8-week

  6. Pressure Pain Threshold [OPTIONAL IN-PERSON VISIT]

    a test of pain sensitivity

    Time frame: baseline, 8-week

  7. Mechanical Temporal Summation [OPTIONAL IN-PERSON VISIT]

    a test of central pain sensitization

    Time frame: baseline, 8-week

  8. Conditioned Pain Modulation [OPTIONAL IN-PERSON VISIT]

    a test of descending pain modulation

    Time frame: baseline, 8-week

  9. Exercise Induced Hypoalgesia [OPTIONAL IN-PERSON VISIT]

    a test of change in pain sensitivity after a bout of exercise

    Time frame: baseline, 8-week

  10. Isometric Knee Extensor Force [OPTIONAL IN-PERSON VISIT]

    knee extensor isometric muscle strength

    Time frame: baseline, 8-week

  11. Isometric Knee Flexor Force [OPTIONAL IN-PERSON VISIT]

    knee flexor isometric muscle strength

    Time frame: baseline, 8-week

  12. Telehealth Usability Questionnaire

    scale evaluating the usability and satisfaction of telehealth implementation and services. Each item is rated on a seven-point Likert scale, with a rating of one indicating disagree and a rating of seven indicating agree; higher ratings indicate better system usability

    Time frame: 8-week

  13. Weekly Log

    log of minutes and days spent doing strengthening exercises, aerobic exercises, and mindfulness practice (mindfulness practice only applicable to people in the TMX group). Survey also includes log of oral analgesic use.

    Time frame: Weekly for 14-weeks

  14. Heal Treatment Expectancy Survey - Short Form

    6-item survey assessing participant's attitude and expectations of the intervention measured on a 5-point likert scale. higher scores indicate more positive attitude and expectations for the treatment

    Time frame: baseline

  15. Treatment History

    a survey that collects information about the treatments the individual has undertaken for their knee osteoarthritis

    Time frame: baseline, week 8, week 14

  16. eHealth Literacy Scale

    8-item scale measuring one's perceived ability and comfort with accessing digital services for health information. each item is rated on a 5-point likert scale. total scores are summed. higher scores indicate greater perceived skills at using online health information to help solve health problems

    Time frame: baseline

07

Results

Posted Jan 16, 2025
Limitations and caveats
There are limitations to consider while interpreting the findings of our study. 1. All outcomes are participant-reported which can introduce bias as we did not include any objective measures (e.g., physical performance). 2. There was lack of diversity in race, education, socioeconomic status, and technological abilities, which limits the external validity of our findings

Participant flow

Baseline to Postintervention (Week 8)
Participant flow — Baseline to Postintervention (Week 8)
MilestoneGroup TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)
Started1921
Completed1918
Not completed03
Withdrew: Brain tumor flare up01
Withdrew: Concussion01
Withdrew: Hernia surgery01
Week 8 to Follow-up (Week 14)
Participant flow — Week 8 to Follow-up (Week 14)
MilestoneGroup TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)
Started1918
Completed1817
Not completed11
Withdrew: Caregiver for sick family member10
Withdrew: Lost to follow-up01

Outcome measures

PrimaryRecruitment

Number of participants that are randomized for the study

Time frame:
through the recruitment process, up to 6 months from the start of the study
Reported as:
Count of participants · Participants
Recruitment
ParticipantsGroup TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)
Recruitment1921
PrimaryAttendance

Proportion of sessions attended

Time frame:
post-intervention (at 8-weeks)
Reported as:
Mean · % sessions attended
Attendance
% sessions attendedGroup TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)
Attendance68 ± 3454 ± 39
PrimaryRetention Rate

Proportion of participants who complete patient-reported outcome surveys

Time frame:
post-intervention visit (at the end of 8-weeks)
Reported as:
Count of participants · Participants
Retention Rate
ParticipantsGroup TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)
Retention Rate1918
PrimaryParticipant Feedback Survey

Custom scale measuring feedback on interventionists and interventions. Scores range from 0-4 (0 - Strongly Disagree, 1 - Disagree, 2 - Neither Agree no Disagree, 3 - Agree, and 4 - Strongly Agree)

Time frame:
8-week
Reported as:
Mean · score on a scale
Participant Feedback Survey
score on a scaleGroup TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)
The exercise instructor demonstrated good knowledge3.56 (2 to 4)3.29 (2 to 4)
The exercise instructor was a good role model3.44 (2 to 4)3.35 (2 to 4)
The exercise instructor explained lessons clearly3.33 (1 to 4)3.38 (2 to 4)
The exercise instructor was engaging3.39 (2 to 4)3.44 (2 to 4)
The exercise instructor was helpful/answered all questions3.33 (1 to 4)3.44 (2 to 4)
I enjoyed the exercise lessons3.11 (1 to 4)2.88 (1 to 4)
I was engaged in the exercise lessons3.39 (1 to 4)3.12 (2 to 4)
I was able to understand the exercise lessons3.56 (2 to 4)3.24 (2 to 4)
I was able to integrate the information from the different exercise lessons3.39 (2 to 4)3.19 (2 to 4)
I will be able to use the exercise lessons in my life3.22 (0 to 4)3.25 (2 to 4)
The mindfulness instructor demonstrated good knowledge—3.35 (2 to 4)
The mindfulness instructor was a good role model—3.35 (2 to 4)
The mindfulness instructor explained lessons clearly—3.24 (2 to 4)
The mindfulness instructor was engaging—3.29 (2 to 4)
The mindfulness instructor was helpful/answered all questions—3.29 (2 to 4)
I enjoyed the mindfulness lessons—2.71 (1 to 4)
I was engaged in the mindfulness lessons—3.12 (2 to 4)
I was able to understand the mindfulness lessons—3.12 (1 to 4)
I was able to integrate the information from the different mindfulness lessons—3.24 (2 to 4)
I will be able to use the mindfulness lessons in my life—3 (2 to 4)
PrimarySatisfaction Scale

Custom 4-item (0-10 scale) to determine satisfaction with individual components of the intervention (i.e.,, exercise, mindfulness, telehealth, and overall satisfaction). There are 4 items and each item is scored separately. Higher scores for each item mean greater satisfaction for that dimension.

Time frame:
8-week
Reported as:
Mean · score on a scale
Satisfaction Scale
score on a scaleGroup TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)
Exercise component8.1 (2.0 to 10.0)8.2 (5.0 to 10.0)
Mindfulness Component—7.3 (2.0 to 10.0)
Telehealth component8.1 (1.0 to 10.0)7.9 (5.0 to 10.0)
General participation7.9 (1.0 to 10.0)8.1 (5.0 to 10.0)
SecondaryKnee Injury and Osteoarthritis Outcome Score

Patient-reported outcome for knee pain and disability; a percentage score from 0 to 100, 0 representing extreme problems and 100 representing no problems.

Time frame:
baseline, 8-week, 14-week
Reported as:
Mean · score on a scale
Knee Injury and Osteoarthritis Outcome Score
score on a scaleGroup TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)
Pain Baseline61.3 (57.6 to 64.9)57.7 (52.6 to 62.7)
Pain Week-863.7 (57.9 to 69.5)61.8 (54.4 to 69.1)
Pain Week-1463.8 (57.3 to 70.3)64.2 (57 to 71.4)
Symptoms Baseline59.7 (54.3 to 65)59.4 (53.9 to 65)
Symptoms Week-863.1 (58.5 to 67.8)59.9 (53.7 to 66.1)
Symptoms Week-1468.8 (63 to 74.5)62.1 (54 to 70.3)
Activity of Daily Living Baseline72.1 (66.7 to 77.6)63 (57.8 to 68.1)
Activity of Daily Living Week-872.6 (66.4 to 78.8)68.2 (60.3 to 76.1)
Activity of Daily Living Week-1471.4 (64.2 to 78.7)68.5 (62.4 to 74.6)
Sports and Recreation Baseline48.1 (37.5 to 58.6)37.4 (31.1 to 43.7)
Sports and Recreation Week-847.2 (34.2 to 60.3)40.6 (32.4 to 48.7)
Sports and Recreation Week-1442.8 (30.6 to 55.1)45.3 (36.5 to 54.1)
Quality Of Life Baseline45.8 (41.6 to 50)41.1 (35.1 to 47.1)
Quality Of Life Week-849 (44.1 to 53.8)48.5 (42.4 to 54.6)
Quality Of Life Week-1452.1 (46.4 to 57.8)52.6 (44.4 to 60.7)
SecondaryPain, Enjoyment, General Activity Scale

Assesses Pain Intensity and Interference. the response range is 0-10; the PEG scale score is the mean of the three individual item scores. Higher scores represent worse pain.

Time frame:
baseline, 8-week, 14-week
Reported as:
Mean · score on a scale
Pain, Enjoyment, General Activity Scale
score on a scaleGroup TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)
Baseline4.9 (4.2 to 5.6)5.4 (4.6 to 6.1)
Week-84 (2.9 to 5)3.9 (3 to 4.7)
Week-143.9 (2.9 to 4.9)3.4 (2.5 to 4.4)
SecondaryNumeric Rating Scale - Nominated Activity

average rating of knee pain from 0-10, where 0 represents no pain and 10 represents worst pain imaginable, in the past week in a nominated activity selected at baseline

Time frame:
baseline, 8-week, 14-week
Reported as:
Mean · score on a scale
Numeric Rating Scale - Nominated Activity
score on a scaleGroup TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)
Baseline6.1 (5.3 to 6.9)6.5 (6.1 to 6.9)
Week-85.1 (4 to 6.2)5.2 (4.4 to 5.9)
Week-144.8 (3.8 to 5.9)4.8 (3.8 to 5.7)
SecondaryParticipant Global Impression of Change

participant's rating of change in condition on a 14-point scale ranging from "a very great deal worse" to "a very great deal better". Values range from -7 to +7 (excluding 0). Score \>=1 represent improvement and scores \<= -1 represent worsening.

Time frame:
8-week, 14-week
Reported as:
Mean · score on a scale
Participant Global Impression of Change
score on a scaleGroup TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)
Week-82.2 (1 to 3.4)2.4 (1.2 to 3.7)
Week-141.4 (0.1 to 2.7)2.2 (1.1 to 3.3)
SecondaryPatient Global Assessment of Osteoarthritis

participant's assessment of impact of osteoarthritis on their general health on a 0-100 mm scale. higher scores represent higher impact of disease or worse global health

Time frame:
baseline, 8-week, 14-week
Reported as:
Mean · score on a scale
Patient Global Assessment of Osteoarthritis
score on a scaleGroup TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)
Baseline59.8 (49.2 to 70.4)63.7 (54.7 to 72.6)
Week-864.5 (54.5 to 74.5)65.7 (56.9 to 74.5)
Week-1460.2 (50.8 to 69.5)68.7 (60.7 to 76.7)
SecondaryPain Catastrophizing Scale

3-item scale which measures of catastrophizing related to pain. Each item is rated on a 5-point scale: 0 (Not at all) to 4 (all the time).

Time frame:
baseline, 8-week
Reported as:
Mean · score on a scale
Pain Catastrophizing Scale
score on a scaleGroup TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)
Baseline3.5 (2.7 to 4.4)3.9 (2.9 to 4.9)
Week-83.4 (2.3 to 4.6)3.1 (2 to 4.1)
SecondaryWidespread Pain Index Symptom Severity Scale

self-report on severity of cognitive symptoms such as fatigue, trouble thinking or remembering, waking up tired, and other physical symptoms such as headache, dizziness, etc. Each symptom is scored on a 4-point scale where 0 indicates no problem and 3 indicates severe problem. Scores are calculated by summing items, with higher scores (out of a maximum score of 12) indicating greater symptom severity.

Time frame:
baseline, 8-week
Reported as:
Mean · score on a scale
Widespread Pain Index Symptom Severity Scale
score on a scaleGroup TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)
Baseline3.9 (3 to 4.8)3.1 (2.2 to 4.1)
Week-84.1 (2.9 to 5.3)3.7 (2.6 to 4.9)
SecondaryPain DETECT

self-report measure on presence of neuropathic pain. each question is scored from 0 to 5 where higher scores indicate higher gradation of pain. The final score is between -1 and 38 and a score of 19 and higher indicates higher likelihood of neuropathic pain

Time frame:
baseline, 8-week
Reported as:
Mean · score on a scale
Pain DETECT
score on a scaleGroup TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)
Baseline9.8 (7.1 to 12.4)8.5 (6.6 to 10.4)
Week-89.4 (7 to 11.8)7.6 (4.9 to 10.4)
SecondaryPatient Health Questionnaire 8-item

8-item questionnaire assessing depression symptoms. Each question is scored from 0 to 3 where higher scores indicate higher frequency of experiencing depressive symptoms. Total score is the sum of individual item scores. Score range is 0-24. Higher total scores indicate greater severity of depression

Time frame:
baseline, 8-week, 14-week
Reported as:
Mean · score on a scale
Patient Health Questionnaire 8-item
score on a scaleGroup TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)
Baseline4.6 (2.3 to 6.9)3 (1.7 to 4.3)
Week-83.7 (2.2 to 5.3)3.9 (1.9 to 6)
Week-143.9 (2.4 to 5.5)4.1 (1.9 to 6.3)
SecondaryCognitive and Affective Mindfulness Scale - Revised

12-item scale on dispositional mindfulness. Items are rated on a 4-point Likert scale from 1 (rarely/not at all) to 4 (almost always). Scores on the scale are summed. Higher scores reflect greater mindfulness.

Time frame:
baseline, 8-week, 14-week
Reported as:
Mean · score on a scale
Cognitive and Affective Mindfulness Scale - Revised
score on a scaleGroup TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)
Baseline35.3 (32.7 to 37.8)37.4 (34.5 to 40.3)
Week-833.9 (30.6 to 37.3)36.4 (33 to 39.9)
Week-1435.2 (32.1 to 38.4)37.3 (33.4 to 41.2)
SecondaryFear Avoidance Beliefs Questionnaire - Physical Activity

4-item questionnaire to determine how one's fear avoidance beliefs contributes to the cognitive/affective part of their knee pain. Each item is scored from 0 to 6. Total scores are summation of each item scores. Range is 0-24. Higher total scores indicate greater fear of physical activity

Time frame:
baseline, 8-week
Reported as:
Mean · score on a scale
Fear Avoidance Beliefs Questionnaire - Physical Activity
score on a scaleGroup TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)
Baseline18.3 (16.1 to 20.5)15.5 (12.9 to 18.1)
Week-816.7 (13.4 to 20)14.8 (11.6 to 18.1)
SecondaryArthritis Self Efficacy Scale

Questionnaire to assess confidence in one's capacity to function despite pain. Each item in the questionnaire is scored on a 1-10 scale. It provides three subscales of pain, function, and other symptoms calculated as average of items contributing to that subscale. Range for each subscale is 1-10. Higher scores indicate greater self-efficacy to manage osteoarthritis.

Time frame:
baseline, 8-week
Reported as:
Mean · score on a scale
Arthritis Self Efficacy Scale
score on a scaleGroup TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)
Pain Baseline6.5 (5.8 to 7.3)6.1 (5.6 to 6.6)
Pain Week-87.1 (6.3 to 7.9)6.2 (5.3 to 7.1)
Function Baseline8 (7.4 to 8.7)7.7 (7.1 to 8.2)
Function Week-88.1 (7.2 to 9.1)8 (7.2 to 8.8)
Other symptoms Baseline7 (6.2 to 7.7)6.8 (6.2 to 7.3)
Other symptoms Week-87.1 (6.3 to 7.9)7.2 (6.4 to 8.1)
SecondaryChronic Pain Self-efficacy Questionnaire

Measures three domains of pain self-efficacy: pain management, physical functioning, and coping with symptoms. Each item is scored on a scale of 0 (very uncertain) to 100 (very certain). Score for each domain is the average of all items contributing to that domain. Higher total scores indicate greater self-efficacy to manage one's chronic pain.

Time frame:
baseline, 8-week
Reported as:
Mean · score on a scale
Chronic Pain Self-efficacy Questionnaire
score on a scaleGroup TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)
Pain Baseline71.5 (64.6 to 78.4)66.2 (59.6 to 72.7)
Pain Week-866.8 (56.8 to 76.8)66.9 (59.1 to 74.8)
Function Baseline86 (78.8 to 93.2)81.4 (74.7 to 88.1)
Function Week-882.2 (72.3 to 92.2)78.2 (66.5 to 89.9)
Coping Baseline68.1 (60.1 to 76)72.6 (66.3 to 78.8)
Coping Week-871.2 (62.1 to 80.3)70.5 (60.6 to 80.5)
Other pre-specifiedArthritis - Rapid Estimate of Adult Literacy in Medicine (A-REALM)

66-word recognition adult health literacy test. Each correct pronunciation of word is scored as 1. The total score is classified into 1 to 4 reading grade levels where higher scores (61-66) represent ninth grade and above reading level

Time frame:
baseline

Results for this outcome have not been posted.

Other pre-specifiedSit to Stand Test [OPTIONAL IN-PERSON VISIT]

functional test that measures the time taken to sit and stand from chair five times

Time frame:
baseline, 8-week

Results for this outcome have not been posted.

Other pre-specified6-minute Walk Test [OPTIONAL IN-PERSON VISIT]

functional test that measures the maximal distance covered while walking at fast-pace for six minutes

Time frame:
baseline, 8-week

Results for this outcome have not been posted.

Other pre-specified7-meter Walk Test [OPTIONAL IN-PERSON VISIT]

functional test that measures comfortable walking speed as participant walks back and forth over 7 meters twice

Time frame:
baseline, 8-week

Results for this outcome have not been posted.

Other pre-specifiedStair Climb Test [OPTIONAL IN-PERSON VISIT]

functional test that measures the time taken to ascend and descend a flight of stairs

Time frame:
baseline, 8-week

Results for this outcome have not been posted.

Other pre-specifiedPressure Pain Threshold [OPTIONAL IN-PERSON VISIT]

a test of pain sensitivity

Time frame:
baseline, 8-week

Results for this outcome have not been posted.

Other pre-specifiedMechanical Temporal Summation [OPTIONAL IN-PERSON VISIT]

a test of central pain sensitization

Time frame:
baseline, 8-week

Results for this outcome have not been posted.

Other pre-specifiedConditioned Pain Modulation [OPTIONAL IN-PERSON VISIT]

a test of descending pain modulation

Time frame:
baseline, 8-week

Results for this outcome have not been posted.

Other pre-specifiedExercise Induced Hypoalgesia [OPTIONAL IN-PERSON VISIT]

a test of change in pain sensitivity after a bout of exercise

Time frame:
baseline, 8-week

Results for this outcome have not been posted.

Other pre-specifiedIsometric Knee Extensor Force [OPTIONAL IN-PERSON VISIT]

knee extensor isometric muscle strength

Time frame:
baseline, 8-week

Results for this outcome have not been posted.

Other pre-specifiedIsometric Knee Flexor Force [OPTIONAL IN-PERSON VISIT]

knee flexor isometric muscle strength

Time frame:
baseline, 8-week

Results for this outcome have not been posted.

Other pre-specifiedTelehealth Usability Questionnaire

scale evaluating the usability and satisfaction of telehealth implementation and services. Each item is rated on a seven-point Likert scale, with a rating of one indicating disagree and a rating of seven indicating agree; higher ratings indicate better system usability

Time frame:
8-week

Results for this outcome have not been posted.

Other pre-specifiedWeekly Log

log of minutes and days spent doing strengthening exercises, aerobic exercises, and mindfulness practice (mindfulness practice only applicable to people in the TMX group). Survey also includes log of oral analgesic use.

Time frame:
Weekly for 14-weeks

Results for this outcome have not been posted.

Other pre-specifiedHeal Treatment Expectancy Survey - Short Form

6-item survey assessing participant's attitude and expectations of the intervention measured on a 5-point likert scale. higher scores indicate more positive attitude and expectations for the treatment

Time frame:
baseline

Results for this outcome have not been posted.

Other pre-specifiedTreatment History

a survey that collects information about the treatments the individual has undertaken for their knee osteoarthritis

Time frame:
baseline, week 8, week 14

Results for this outcome have not been posted.

Other pre-specifiedeHealth Literacy Scale

8-item scale measuring one's perceived ability and comfort with accessing digital services for health information. each item is rated on a 5-point likert scale. total scores are summed. higher scores indicate greater perceived skills at using online health information to help solve health problems

Time frame:
baseline

Results for this outcome have not been posted.

Adverse events

Collected over 14-weeks. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Group TX (Telehealth Exercise)0/19 (0%)0/19 (0%)8/19 (42.1%)
Group TMX (Telehealth Exercise and Mindfulness)0/21 (0%)0/21 (0%)3/21 (14.3%)
Most frequent other events
Most frequent other events
EventGroup TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)
Exacerbation of knee painMusculoskeletal and connective tissue disorders4/190/21
FluInfections and infestations2/191/21
Knee replacement surgerySurgical and medical procedures1/190/21
Generally feeling unwellGeneral disorders1/190/21
Hernia surgerySurgical and medical procedures0/191/21
Ankle injuryMusculoskeletal and connective tissue disorders0/191/21

Baseline characteristics

Age, Continuous
Age, Continuous(years)Group TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)Total
Mean67.4 ± 7.463.8 ± 8.965.5 ± 8.3
Sex: Female, Male
Sex: Female, Male(Participants)Group TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)Total
Female171835
Male235
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Group TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)Total
American Indian or Alaska Native000
Asian011
Native Hawaiian or Other Pacific Islander000
Black or African American101
White181937
More than one race000
Unknown or Not Reported011
Education
Education(Participants)Group TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)Total
High school or College 1 - 3 years6814
Undergraduate, graduate, or doctorate131326
Annual income
Annual income(Participants)Group TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)Total
More than 50,000$101121
Less than 50,000$8917
Did not report112
Marital Status
Marital Status(Participants)Group TX (Telehealth Exercise)Group TMX (Telehealth Exercise and Mindfulness)Total
Married91019
Widowed, divorced, single, or not reported101121
08

Study locations

1 site
  • Movement and Applied Imaging Lab, Boston University
    Boston, Massachusetts 02215, United States
09

References and documents

Study documents

  • Protocol and statistical analysis plan · Nov 15, 2023
  • Informed consent form · Feb 5, 2023

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No — Requests will be considered on an individual basis

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jan 16, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT05524116
Lead sponsor
Boston University Charles River Campus
Responsible party
Deepak Kumar (Assistant Professor, Boston University Charles River Campus) — Principal investigator
First posted
Sep 1, 2022
Start date
Oct 4, 2022
Primary completion
Jun 6, 2023
Completion
Jul 3, 2023
Results posted
Jan 16, 2025
Last update
Jan 16, 2025

Study contacts

Deepak Kumar, PT, PhD
principal investigator · Boston University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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