To examine changes in pain, disability, and pain sensitization after a behavioral graded activity (BGA) program in people with knee osteoarthritis (KOA) who had not responded to guideline-concordant exercise.
Approach:
Key Findings:
Linear mixed models showed significant improvements in KOOS pain and activities of daily living, exceeding the minimal important change.
PPT increased at both the knee and forearm, while TSP decreased.
Increased physical activity was noted, with baseline step count positively correlating with improvements in KOOS activities of daily living.
Interpretation:
Improvements in KOOS were accompanied by changes in PPT and TSP over the 12-week BGA program in KOA patients who had not responded to guideline-concordant exercise.
Limitations:
Single-arm trial design limits comparison with a control group.
Small sample size may affect generalizability of findings.
Lack of long-term follow-up to assess sustainability of improvements.
Conclusion:
Future randomized controlled trials are needed to determine whether sensory changes are attributable to BGA and to identify patient characteristics associated with treatment response.
