BEPKO-3
Research type
Research Study
Full title
BEhaviour change for People with clinically diagnosed Knee Osteoarthritis: A pragmatic trial (BEPKO-3)
IRAS ID
350962
Contact name
Stephen Preece
Contact email
Sponsor organisation
The University of Salford
Clinicaltrials.gov Identifier
8360, UoS Ethics reference number
Duration of Study in the UK
3 years, 0 months, 0 days
Research summary
Knee osteoarthritis (OA) is a common long-term condition that causes pain, stiffness, and difficulty with everyday activities. It affects around 10% of people over 55 in the UK. The recommended treatment is therapeutic exercise, often delivered by a physiotherapist. However, many people do not experience relief from this approach and may eventually be referred for knee replacement surgery.
This study is funded by the National Institute for Health and Care Research (NIHR) and led by the University of Salford. The trial will involve 252 people with knee OA who have tried exercise therapy but are dissatisfied with the outcome. Participants will be randomly assigned to one of two groups: Cognitive Muscular Therapy (CMT) plus NHS usual care or usual NHS care alone. Usual care refers to any steps a person might take to manage their knee pain or improve movement, and includes pharmacological management, joint injection and surgery.
CMT is a physiotherapy-led programme that combines psychological techniques with muscle retraining. It helps people understand their pain, challenge unhelpful beliefs, and learn to reduce muscle overactivity, which is often linked to increased joint stress and pain. Visual feedback using skin-mounted sensors is used to enable patients to visualise muscle overactivity during the treatment. CMT is delivered over seven, one-hour sessions by specially trained physiotherapists.
The research will assess whether CMT improves pain and function at 6 and 12 months after starting the trial. It will also evaluate how cost-effective the treatment is and explore participants’ and physiotherapists’ experiences through interviews and surveys.
If successful, CMT could be offered on the NHS as a second-line treatment, following exercise. This may help people manage their condition more effectively and potentially reduce the need for invasive procedures, such as knee replacement.REC name
Wales REC 3
REC reference
25/WA/0329
Date of REC Opinion
19 Nov 2025
REC opinion
Favourable Opinion