Randomised controlled trial of the effects of a self-management patient education program on overall quality of life and knee pain of older people with mild to moderate knee(s) osteoarthritis


  • Alhadi M. Jahan School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada




Osteoarthritis, Patient education, Physiotherapy, Quality of life


Background: Knee osteoarthritis (OA) is the most important chronic rheumatic disease affecting human beings. It is more common among the older population. The objective of OA treatment is to control the symptoms, such as pain, mobility problems and consequently, to improve overall quality of life. Although, self-management patient education programs, such as educational workshops and other learning activities are effective approaches in some chronic diseases, the evidence for arthritis is still inconclusive. The aim of this trial is to compare the effectiveness of an OA of the knee self-management education program with a control group, as determined by improvements in pain and quality of life.

Methods: In this study, we will perform a two-group, randomized (1:1 ratio), controlled study with repeated-measures to examine the differences between the two groups over time. The research sample will be selected from the patients who are referred to a physiotherapy department with a diagnosed mild to moderate knee(s) OA, aging from 45 to 65 years.

Conclusions: Positive findings of this trial will pave the road for new methods of cooperation between patients and healthcare providers. Also, patient education ensures that patients are well-informed about their own health and they could avoid any deterioration and disability due to bad practices. Finally, an increased understanding helps patients to make informed decisions about their healthcare avenues.


Ratzlaff CR, Liang M. Prevention of injury-related knee osteoarthritis: Opportunities for the primary and secondary prevention of knee osteoarthritis. Arthritis Res Ther. 2010;12(4):215.

Brosseau L, Wells G, Kenny G, Reid R, Maetzel A, Tugwell P, et al. The implementation of a community- based aerobic walking program for mild to moderate knee osteoarthritis (OA): A knowledge translation (KT) randomized controlled trial (RCT): Part I: The uptake of the ottawa panel clinical practice guidelines (CPGs). BMC Public Health. 2012;12(1):871.

Nuñez M, Nuñez E, Segur JM, Macule F, Quinto L, Hernandez MV, et al. The effect of an educational program to improve health-related quality of life in patients with osteoarthritis on waiting list for total knee replacement: A randomized study. Osteoarthritis Cartil. 2006;14(3):279-85.

Adams KF, Schatzkin A, Harris TB. Overweight, obesity, and mortality in A large prospective cohort of persons 50 to 71 years old. J Vascular Surg. 2006;44(6):1374.

Brosseau L, Wells GA, Tugwell P, Egan M, Wilson KG, Dubouloz C, et al. Ottawa panel evidence- based clinical practice guidelines for patient education in the management of rheumatoid arthritis (RA). Health Educ J. 2012;71(4):397-451.

Coleman S, Briffa K, Conroy H, Prince R, Carroll G, McQuade J. Short and medium- term effects of an education self- management program for individuals with osteoarthritis of the knee, designed and delivered by health professionals: A quality assurance study. BMC Musculoskeletal Disorders. 2008;9:117.

Cameron R, Brown KS, Best JA. The dissemination of chronic disease prevention programs: Linking science and practice. Canadian J Public Health. 1996;87(2):50.

King L, Hawe P, Wise M. Making dissemination a two- way process. Health Promot Int. 1998;13(3):237-44.

Nutbeam D. Improving the fit between research and practice in health promotion: Overcoming structural barriers. Canadian J Public Health. 1996;87(2):18.

Orleans CT. Addressing multiple behavioral health risks in primary care: Broadening the focus of health behavior change research and practice. Am J Prev Med. 2004;27(2):1-3.

Garcia YE, Others A. A senior peer counseling program: Evaluation of training and benefits to counselors. Educational Gerontol. 1997;23(4):329-44.

Petty BJ, Cusack SA. Assessing the impact of a seniors’ peer counseling program. Educational Gerontol. 1989;15(1):49-64.

Bombardier C, Melfi CA, Paul J, Green R, Hawker G, Wright J, et al. Comparison of a generic and a disease- specific measure of pain and physical function after knee replacement surgery. Med Care. 1995;33(4):131-44.

Carr A. Adult measures of quality of life: The arthritis impact measurement scales (AIMS/AIMS2), disease repercussion profile (DRP), EuroQoL, nottingham health profile (NHP), patient generated index (PGI), quality of Well‐Being scale (QWB), RAQoL, short Form‐36 (SF‐36), sickness impact profile (SIP), SIP‐RA, and world health organization's quality of life instruments (WHOQoL, WHOQoL‐100, WHOQoL‐Bref. Arthritis Care & Res. 2003;49:113.

Bellamy N. Pain assessment in osteoarthritis: Experience with the WOMAC osteoarthritis index. Semin Arthritis Rheum. 1989;18(4):14-7.

Canadian Agency for Drugs and Technologies, in Health. Guidelines for the economic evaluation of health technologies canada. 3rd ed. Ottawa, Ont: Canadian Agency for Drugs and Technologies in Health, 2006. 2006.

Stan GF, Orban HF, Orban C. Cost effectiveness analysis of knee osteoarthritis treatment. Chirurgia (Bucur). 2015;110(4):368-74.






Original Research Articles