BEPKO

• Research type

  Research Study

• Full title

  The feasibility of using BiofEedback to reduce Pain in people with Knee Osteoarthritis (BEPKO).

• IRAS ID

  232749

• Contact name

  C Starbuck

• Contact email

  c.starbuck@salford.ac.uk

• Sponsor organisation

  University of Salford

• Duration of Study in the UK

  2 years, 0 months, 1 days

• Research summary

  Research Summary
  This NIHR funded project is aimed at developing a new treatment for people with knee osteoarthritis OA. This fundamental idea behind this treatment is to teach people with knee OA to reduce the amount of muscle tension in their knee muscles (hamstrings and quadriceps) during daily activities using EMG (muscle measurement) biofeedback. There are two main parts to the project. The first is to create a database of EMG signals, which is necessary to develop the biofeedback software. This will be created from both healthy people and those with knee OA. The second aim is to try out the new treatment on people with knee OA, to obtain their feedback and then to use this feedback to improve subsequent interactions of the intervention.

  Summary of Results
  Who carried out the research?
  The study was funded through a National Institute of Health Research (NIHR) grant. The research was carried out by the University of Salford, Manchester in conjunction with the following NHS sites:
  - Salford Royal Hospital (Northern Care Alliance NHS Foundation Trust)
  - Kingsgate House (Stockport NHS Foundation Trust)
  - Manchester Royal Infirmary (Manchester University NHS Foundation Trust)
  - Fairfield General Hospital (Northern Care Alliance NHS Foundation Trust)
  These sites helped to recruit participants and supported the delivery of the treatment.

  Aims and objectives:
  To develop a new treatment for people with knee osteoarthritis (KOA) which can improve muscle coordination and reduce pain. We aimed to develop different components of the treatment through extensive patient/physiotherapist consultation.

  Background:
  Previous research shows that people with KOA over tighten their knee muscles when they stand, walk and perform other activities. These muscle patterns increase the pressure on the knee joint and may increase pain.

  Methods:
  We performed two phases of interventions development, testing, user consultation and refinement. A total of 19 patients received between 4-6 sessions of the intervention at different stages of development.

  Key findings:
  Our new treatment guides patients through a gradual relearning of muscle patterns in standing, walking and other activities. To facilitate this process, we use animated instructional videos to explain muscle patterns and teach patients to think differently about their muscle coordination. We also use skin-mounted muscle sensors to visualise muscle patterns on a computer screen. Clinical data from the final 11 patients showed reductions in knee pain of 38-100%

  Dissemination, outputs and impact:
  If future large-scale trials show this treatment to be effective for KOA, it could be implemented on the NHS. Our work has been published in a scientific journal (BMC Musculoskeletal Disorders).

  Patient and public involvement
  We involved patients in research design and sought patient feedback on our intervention through focus groups and individual consultation. This feedback was used to create the final intervention.

  Conclusions and future plans:
  We have developed a new intervention for KOA which can be delivered in 6 one-to-one sessions by a physiotherapist. We now plan to run a feasibility trial which will allow us to begin to understand how our new treatment compares to the current physiotherapy practice of knee muscle strengthening.

  Where can I learn more about this study?
  Use this link https://eur03.safelinks.protection.outlook.com/?url=http%3A%2F%2Furl6570.hra.nhs.uk%2Fls%2Fclick%3Fupn%3DXv3JSvJ-2B3M71ppf7N9agbY9boIUUXHyl6029vA5VGbc-3D9jrg_E1aO2-2BZlVOSJJV-2FajQqskegTd6IRomHYTi-2Fbt8SH3YIkt-2FWJp7gGFk-2BXggneYlTtbjIgalTHIyJySA3A5jofE9EjGRZJ7z3aDhpvapUnd2UJdhcVj7ipSqpJtr5APrRnw22PTvT8h8NNBt1Rr-2F-2Fl5a2OB9a5OeERq2O0A2pZCiq-2BVa0WFejYEpAuRIJvJdZCdoMzg48yukZbwREeC6DvKSjr2COQAuRLn2lS32cliQI-3D&data=04%7C01%7Capprovals%40hra.nhs.uk%7C4f3ba5a73bab4aefcc5f08da037fdbb2%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C637826144923769938%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000&sdata=qizqcDdYgFL2K9UqMM%2FMr%2BPYqjCd4WrhiNj9xfRuULs%3D&reserved=0 to access our publication in the BMC Musculoskeletal Disorders journal.

• REC name

  North West - Greater Manchester East Research Ethics Committee

• REC reference

  18/NW/0282

• Date of REC Opinion

  1 May 2018

• REC opinion

  Favourable Opinion