Cuyul-Vásquez Iván, Fuentes C Jorge
Departamento de Procesos Terapéuticos, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Temuco, Chile. ORCID: 0000-0002-0511-0503.
Laboratorio de Investigación Clínica, Departamento de Kinesiología, Universidad Católica del Maule, Talca, Chile. Dirección: Av. San Miguel 3605, Talca, Chile, Zip code: 3460000. Email:
Medwave. 2021 Apr 16;21(3):e8160. doi: 10.5867/medwave.2021.03.8159.
Previous evidence has shown that seniors physical therapists applying electrotherapy and an enhanced therapeutic alliance in their sessions can positively influence the levels of analgesia of patients with chronic low back pain. It is currently unknown if these effects can be achieved in people with symptomatic knee osteoarthritis when receiving treatment focused on therapeutic exercise.
To determine the effects of different therapeutic alliance levels during the application of a therapeutic exercise program on pain intensity and pressure pain threshold in patients with symptomatic knee osteoarthritis.
This will be a randomized, parallel, two-arm, clinical trial. An intervention of three sessions of therapeutic exercise will be applied for one week. Patients aged 45 to 65 years old with a clinical and radiographic diagnosis of knee osteoarthritis will participate. Also, patients with a pain intensity of at least three months duration and 3 to 8 points in a numerical rating scale will be included. Patients will be randomly assigned to a therapeutic exercise experimental group with an enhanced therapeutic alliance (e.g., active listening, personalized conversation, empathy) or limited therapeutic alliance (e.g., one-way verbalization, brief interaction). Physical therapists will be trained in delivering these two levels of the therapeutic alliance. The pressure pain thresholds at the symptomatic knee and the pain intensity will be measured before and after the intervention.
The results of this research will determine the impact of the therapeutic alliance as a nonspecific relevant factor during the application of a therapeutic exercise program in the treatment of patients with symptomatic knee osteoarthritis.
NCT04390932.
先前的证据表明，老年物理治疗师在治疗过程中应用电疗法并加强治疗联盟，可对慢性下腰痛患者的镇痛水平产生积极影响。目前尚不清楚，对于有症状的膝骨关节炎患者，在接受以治疗性运动为主的治疗时，是否能取得同样效果。
确定在对有症状的膝骨关节炎患者实施治疗性运动方案时，不同水平的治疗联盟对疼痛强度和压痛阈值的影响。
这将是一项随机、平行、双臂临床试验。将进行为期一周、共三节的治疗性运动干预。年龄在45至65岁、临床和影像学诊断为膝骨关节炎的患者将参与。此外，疼痛强度持续至少三个月且数字评分量表评分为3至8分的患者也将纳入。患者将被随机分配到治疗性运动实验组，一组接受加强治疗联盟（如积极倾听、个性化交谈、共情），另一组接受有限治疗联盟（如单向言语表达、简短互动）。物理治疗师将接受提供这两种治疗联盟水平的培训。在干预前后测量患侧膝关节的压痛阈值和疼痛强度。
本研究结果将确定治疗联盟作为非特异性相关因素，在对有症状的膝骨关节炎患者应用治疗性运动方案进行治疗时所产生的影响。
NCT04390932。
