Effects of Motivational Interviewing on Pain Self-Efficacy and Exercise Behavior in Individuals With Knee Osteoarthritis

Condition(s) studied

Investigational drug(s) / intervention(s)

Motivational Interviewing: Motivational interviewing will be delivered individually in face-to-face sessions by a researcher trained and certified in motivational interviewing. Sessions will focus on identifying individual barriers and goals, strengthening motivation and commitment to exercise, supporting self-efficacy, and preventing relapse. The intervention will incorporate three stages: increasing exercise motivation, strengthening commitment to exercise, and relapse prevention.

Neuromuscular Exercise Program: Participants will perform neuromuscular exercise sessions five times per week for four weeks. Each 60-minute session will consist of approximately 10 minutes of warm-up, 40 minutes of exercise, and 10 minutes of cool-down. Exercises will include core stabilization and postural control, postural orientation, lower-extremity strengthening, functional exercises, and balance and proprioception exercises. Exercises will be progressed according to participant tolerance and functional performance.

Home Exercise Program: The home exercise program will include isometric strengthening exercises for the quadriceps and hip adductor muscles, straight leg raising, assisted hip and knee flexion, and active knee flexion exercises. Participants will perform the program five days per week, twice daily, for three weeks, with 10 repetitions of each exercise. The program will be explained and demonstrated by a physiotherapist during the first session, and adherence will be followed by telephone contact.

Study summary

This randomized controlled trial aims to investigate the effects of motivational interviewing added to a neuromuscular exercise and home exercise program on pain self-efficacy, exercise behavior, pain intensity, physical performance, and functional status in individuals with knee osteoarthritis. Sixty individuals diagnosed with knee osteoarthritis will be randomly allocated to either an intervention group or a control group. The intervention group will receive motivational interviewing in addition to neuromuscular exercise and a home exercise program, whereas the control group will receive neuromuscular exercise and the same home exercise program. Outcomes will be assessed at baseline, immediately after the intervention, and six weeks after the intervention.

Eligibility

Primary outcome measure(s)

• The Exercise Self-Efficacy Scale (ESE) — Baseline, immediately after the 4-week intervention, and 6 weeks after completion of the intervention
  The Exercise Self-Efficacy Scale (ESE) measures a person's confidence in their ability to maintain regular physical activity or exercise when facing various internal and external barriers. Different validated versions exist, including Albert Bandura's 18-item scale, an older adult 9-item scale, and a 10-item spinal cord injury adaptation.
• Pain Self-Efficacy Questionnaire (PSEQ) — Baseline, immediately after the 4-week intervention, and 6 weeks after completion of the intervention
  The Pain Self-Efficacy Questionnaire (PSEQ) is a 10-item self-report tool designed to measure a person's confidence in performing daily activities and functioning normally despite ongoing chronic pain. It uses a 7-point scale from 0 to 6, yielding total scores between 0 and 60, where higher scores reflect stronger coping confidence.

Trial sites (1)

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