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Randomized Trial in knEe Osteoarthritis Using Low Intensity Ultrasound - Evaluating Feasibility (RELIEF) (RELIEF)

Primary Purpose

Knee Osteoarthritis

Status
Terminated
Phase
Not Applicable
Locations
Canada
Study Type
Interventional
Intervention
low intensity, pulsed ultrasound
sham ultrasound
Sponsored by
McMaster University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Knee Osteoarthritis focused on measuring Ultrasound therapy, Tibiofemoral joint, medial, Nonsurgical

Eligibility Criteria

40 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • over 40 years of age;
  • have medial tibiofemoral compartment knee OA;
  • have mild to moderate medial compartment radiographic OA severity (determined by the attending surgeon and/or Advanced Practice Physiotherapist on the basis of a standing x-ray or MRI scan depending upon which is available at initial consult);
  • have stable ('not getting worse or better overall despite short-term fluctuations during the past three months') pain having an average intensity ≥ 3 and ≤ 8 on an 11-point verbal numeric rating scale, VNRS) in one knee which is aggravated by activity and eased with rest;
  • limited pain from other lower extremity joints; and
  • no change in first line pain medication in the past 2 months and willingness to forego alterations in pain medication for the duration of the study unless deemed medically necessary.

Exclusion Criteria:

  • history of traumatic OA or previous surgical intervention in the knee or knee effusion;
  • intra-articular injection of the knee in the previous 6 months;
  • received ultrasound treatment for knee OA within the past 6 months;
  • body weight changed ≥ 5% in the past 2 months;
  • level of physical function insufficient to perform the required assessments or administer the intervention (e.g. intermittent claudication, severe peripheral neuropathy, active proliferative retinopathy, unstable cardiac or pulmonary disease, disabling stroke, chronic pain, arthritis in joints other than the study knee, bone fracture in the past 3 months);
  • conditions listed as precautions or unknown safety risks for using the EXOGEN EXPRESS ultrasound device (pregnant or nursing women, individuals with thrombophlebitis, vascular insufficiency, abnormal skin sensitivity, sensory paralysis, open wound at the medial joint line of the knee, taking steroids/anti-coagulants, prescription non-steroidal anti-inflammatory, calcium channel blocker or applying the EXOGEN EXPRESS in close proximity to someone wearing a cardiac pacemaker);
  • unable to read, write and/or understand English;
  • other illness or reasons judged by the participant, clinicians or researchers to make participation inadvisable (e.g. plans to move or travel, cognitive deficit resulting in difficulty comprehending and complying with instructions, caregiving demands/lack of social support for participation);
  • unwillingness to sign informed consent; or
  • participation in a competing study.

Sites / Locations

  • Regional Joint Assessment Program - HHS/SJHH

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Sham Comparator

Arm Label

Low intensity, pulsed ultrasound

Sham ultrasound

Arm Description

Outcomes

Primary Outcome Measures

Rate of recruitment
Ability to recruit 30 participants over a 6 month period
Adherence to study protocol
Percent adherence to the protocols for randomization, recruitment, intervention, and assessment
Rate of retention
Number of participants completing the trial
Rate of all adverse events
Participants will be asked about serious and non-serious adverse events weekly during the 13 week intervention phase and monthly during the 13 week follow up phase. All adverse events will be recorded and addressed as indicated.

Secondary Outcome Measures

Western Ontario and McMaster Osteoarthritis Index (WOMAC)3.1NPR pain subscale
Change from baseline in pain at 13 weeks
Western Ontario and McMaster Osteoarthritis Index (WOMAC)3.1NPR physical function subscale
Change from baseline in Physical Function at 26 weeks
6 Minute Walk Test (6MWT)
Change from baseline distance (metres) walked in 6 minutes at 26 weeks
SF-36 (RAND 36-item Health Survey 1.0)
Change from baseline in Health Related Quality of Life at 26 weeks
Global Rating of Disease Severity
Change from baseline in Global Rating of Disease Severity at 13 and 26 weeks will be assessed using an 11-point scale ('Considering all the ways that your knee arthritis affects you, please rate how you are doing on a scale from 0 (very well) to 10 (very poor))
11-point Verbal Numeric Rating Scale (VNRS)
Change from baseline in pain intensity (average, minimum and maximum over the past 24 hours and following physical performance tests)
Lower Extremity Functional Scale (LEFS)
Change from baseline in physical function at 26 weeks
Stair Climb test
Time (seconds) to ascend and descend a staircase with 9 steps
Perceived change
Perceived change from baseline will be assessed at 13 and 26 weeks using an 11-point scale ('With respect to your OA knee treated with ultrasound, how would you describe yourself now compared to baseline assessment?' -5 = a very great deal worse, 0 = about the same, +5 = a very great deal better)

Full Information

First Posted
May 31, 2012
Last Updated
April 7, 2015
Sponsor
McMaster University
Collaborators
Bioventus LLC, Canadian Institutes of Health Research (CIHR)
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1. Study Identification

Unique Protocol Identification Number
NCT01623804
Brief Title
Randomized Trial in knEe Osteoarthritis Using Low Intensity Ultrasound - Evaluating Feasibility (RELIEF)
Acronym
RELIEF
Official Title
Can Very Low Intensity Ultrasound Therapy Improve Pain in People With Knee Osteoarthritis? A Pilot Randomized Controlled Trial
Study Type
Interventional

2. Study Status

Record Verification Date
April 2015
Overall Recruitment Status
Terminated
Why Stopped
funding to support alternate feasible recruitment strategy was not acquired
Study Start Date
July 2012 (undefined)
Primary Completion Date
August 2014 (Actual)
Study Completion Date
August 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
McMaster University
Collaborators
Bioventus LLC, Canadian Institutes of Health Research (CIHR)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this pilot study is to determine the feasibility of conducting a high quality clinical trial to investigate the effects of low intensity, pulsed ultrasound on knee osteoarthritis pain and physical function.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Knee Osteoarthritis
Keywords
Ultrasound therapy, Tibiofemoral joint, medial, Nonsurgical

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
1 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Low intensity, pulsed ultrasound
Arm Type
Active Comparator
Arm Title
Sham ultrasound
Arm Type
Sham Comparator
Intervention Type
Device
Intervention Name(s)
low intensity, pulsed ultrasound
Other Intervention Name(s)
Exogen Express Ultrasound Bone Healing System
Intervention Description
1.5MHz, spatial average-temporal average intensity = 0.03W/cm2, pulsed (burst frequency 1kHz, burst duration 200µm, duty cycle 20%); self-administered to the medial side of the knee joint while sitting down for 20 minutes every day for 3 months.
Intervention Type
Device
Intervention Name(s)
sham ultrasound
Other Intervention Name(s)
sham Exogen Express Ultrasound Bone Healing System
Intervention Description
no ultrasonic energy emitted; self-administered to the medial side of the knee joint while sitting down for 20 minutes every day for 3 months
Primary Outcome Measure Information:
Title
Rate of recruitment
Description
Ability to recruit 30 participants over a 6 month period
Time Frame
6 months
Title
Adherence to study protocol
Description
Percent adherence to the protocols for randomization, recruitment, intervention, and assessment
Time Frame
26 weeks
Title
Rate of retention
Description
Number of participants completing the trial
Time Frame
26 weeks
Title
Rate of all adverse events
Description
Participants will be asked about serious and non-serious adverse events weekly during the 13 week intervention phase and monthly during the 13 week follow up phase. All adverse events will be recorded and addressed as indicated.
Time Frame
26 weeks
Secondary Outcome Measure Information:
Title
Western Ontario and McMaster Osteoarthritis Index (WOMAC)3.1NPR pain subscale
Description
Change from baseline in pain at 13 weeks
Time Frame
13 weeks
Title
Western Ontario and McMaster Osteoarthritis Index (WOMAC)3.1NPR physical function subscale
Description
Change from baseline in Physical Function at 26 weeks
Time Frame
26 weeks
Title
6 Minute Walk Test (6MWT)
Description
Change from baseline distance (metres) walked in 6 minutes at 26 weeks
Time Frame
26 weeks
Title
SF-36 (RAND 36-item Health Survey 1.0)
Description
Change from baseline in Health Related Quality of Life at 26 weeks
Time Frame
26 weeks
Title
Global Rating of Disease Severity
Description
Change from baseline in Global Rating of Disease Severity at 13 and 26 weeks will be assessed using an 11-point scale ('Considering all the ways that your knee arthritis affects you, please rate how you are doing on a scale from 0 (very well) to 10 (very poor))
Time Frame
26 weeks
Title
11-point Verbal Numeric Rating Scale (VNRS)
Description
Change from baseline in pain intensity (average, minimum and maximum over the past 24 hours and following physical performance tests)
Time Frame
0 and 13 weeks
Title
Lower Extremity Functional Scale (LEFS)
Description
Change from baseline in physical function at 26 weeks
Time Frame
26 weeks
Title
Stair Climb test
Description
Time (seconds) to ascend and descend a staircase with 9 steps
Time Frame
26 weeks
Title
Perceived change
Description
Perceived change from baseline will be assessed at 13 and 26 weeks using an 11-point scale ('With respect to your OA knee treated with ultrasound, how would you describe yourself now compared to baseline assessment?' -5 = a very great deal worse, 0 = about the same, +5 = a very great deal better)
Time Frame
13 and 26 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: over 40 years of age; have medial tibiofemoral compartment knee OA; have mild to moderate medial compartment radiographic OA severity (determined by the attending surgeon and/or Advanced Practice Physiotherapist on the basis of a standing x-ray or MRI scan depending upon which is available at initial consult); have stable ('not getting worse or better overall despite short-term fluctuations during the past three months') pain having an average intensity ≥ 3 and ≤ 8 on an 11-point verbal numeric rating scale, VNRS) in one knee which is aggravated by activity and eased with rest; limited pain from other lower extremity joints; and no change in first line pain medication in the past 2 months and willingness to forego alterations in pain medication for the duration of the study unless deemed medically necessary. Exclusion Criteria: history of traumatic OA or previous surgical intervention in the knee or knee effusion; intra-articular injection of the knee in the previous 6 months; received ultrasound treatment for knee OA within the past 6 months; body weight changed ≥ 5% in the past 2 months; level of physical function insufficient to perform the required assessments or administer the intervention (e.g. intermittent claudication, severe peripheral neuropathy, active proliferative retinopathy, unstable cardiac or pulmonary disease, disabling stroke, chronic pain, arthritis in joints other than the study knee, bone fracture in the past 3 months); conditions listed as precautions or unknown safety risks for using the EXOGEN EXPRESS ultrasound device (pregnant or nursing women, individuals with thrombophlebitis, vascular insufficiency, abnormal skin sensitivity, sensory paralysis, open wound at the medial joint line of the knee, taking steroids/anti-coagulants, prescription non-steroidal anti-inflammatory, calcium channel blocker or applying the EXOGEN EXPRESS in close proximity to someone wearing a cardiac pacemaker); unable to read, write and/or understand English; other illness or reasons judged by the participant, clinicians or researchers to make participation inadvisable (e.g. plans to move or travel, cognitive deficit resulting in difficulty comprehending and complying with instructions, caregiving demands/lack of social support for participation); unwillingness to sign informed consent; or participation in a competing study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Norma J MacIntyre, PT, PhD
Organizational Affiliation
McMaster University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Regional Joint Assessment Program - HHS/SJHH
City
Hamilton
State/Province
Ontario
ZIP/Postal Code
L8S 1C7
Country
Canada

12. IPD Sharing Statement

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Randomized Trial in knEe Osteoarthritis Using Low Intensity Ultrasound - Evaluating Feasibility (RELIEF)

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