Physical Therapy Program and Treatment Expectations in Knee Osteoarthritis

May 24, 2026 updated by: Levent Karataş, Gazi University

Evaluating The Predictive Effect of Treatment Expectations on Response to A Physical Therapy Program in Patients With Knee Osteoarthritis

To our knowledge, no studies have been conducted in the literature investigating the relationship between the success of physical therapy programs applied in knee osteoarthritis and patients' pre-treatment expectations. The rationale for this study is to demonstrate the possible relationship between treatment expectations and the benefits seen from conventional physical therapy programs in patients with knee osteoarthritis, and to provide clinicians with a different perspective in knee osteoarthritis treatment planning.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Osteoarthritis, also called degenerative joint disease, primarily occurs in old age, but can also develop after trauma or secondarily to diseases such as rheumatoid arthritis and hemochromatosis. Osteoarthritis is the most common joint disease worldwide. The pathophysiology of osteoarthritis is responsible for the failed repair of joint damage caused by stress initiated by any joint or periarticular tissue abnormality. The most common symptom of osteoarthritis is pain. Factors associated with an increased risk of knee osteoarthritis include advanced age, family history, overweight or obesity, a history of knee trauma, occupational factors, and varus or valgus alignment. Long-term complications of osteoarthritis include decreased physical activity, loss of fitness, sleep disturbances, fatigue, and depression. With the increasing aging population, degenerative joint problems have become a concern for a large part of society. Exercise is a key component in the treatment of this chronic disease, which restricts functionality and reduces quality of life. A systematic review of 54 randomized controlled trials involving a total of 5362 participants showed that different types of exercise improved pain, functionality, and quality of life in knee osteoarthritis. Studies have shown that treatment outcomes are not always similar in patients undergoing similar treatment programs, and that patients' expectations from treatment can also influence results. A systematic literature review on improvement expectations revealed that in 15 out of 16 studies, positive patient expectations were associated with better health outcomes. A recent study in the field of physical therapy also showed that in the treatment of chronic low back pain, high patient expectations were associated with the success of the treatment. Therefore, we planned this study to answer the questions of whether treatment expectations have a predictive effect on the benefits seen from an exercise program in patients with knee osteoarthritis, and whether it is necessary to evaluate the level of expectations when creating a treatment program for patients with knee osteoarthritis.

Study Type

Observational

Enrollment (Estimated)

84

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

  • Name: Levent Karatas
  • Phone Number: +9005055629437

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Probability Sample

Study Population

Patients aged 50 years and older who present with knee pain and are found to have grade 2 or higher gonarthrosis according to the Kellgren-Lawrence classification on X-ray imaging.

Description

Inclusion Criteria:

  • Agreeing to participate in the study
  • Being over 50 years of age
  • Having a clinically and radiographically confirmed diagnosis of knee osteoarthritis
  • Having grade 2-3-4 knee osteoarthritis according to the Kellgren-Lawrence grading system
  • Being literate

Exclusion Criteria:

  • Previous knee surgery
  • Conditions that prevent exercise (such as incurable malignancy, active systemic infection, non-union fracture)
  • Presence of accompanying neurological disease affecting the lower extremity
  • Severe cognitive impairment (neuropsychiatric disease or condition that will impede cooperation, such as psychosis, dementia)
  • History of having received injections or other procedures to the knee joint or physical therapy within the last 6 months

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Those with Low Treatment Expectations
Other: Physical Therapy
Patients in both groups will receive 15 sessions of a conventional physical therapy program.
Those with High Treatment Expectations
Other: Physical Therapy
Patients in both groups will receive 15 sessions of a conventional physical therapy program.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The Western Ontario and McMaster Universities Arthritis Index (WOMAC) score
Time Frame: From enrollment day to the end of the rehabilitation program at 4 weeks
WOMAC score evaluation following the last treatment session. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is a widely used, validated questionnaire designed to assess pain, stiffness, and physical function in patients with knee and hip osteoarthritis. It consists of 24 items divided into three subscales: pain (5 items), stiffness (2 items), and physical function (17 items). Patients rate their symptoms on a Likert scale, with higher scores indicating worse pain, stiffness, or functional limitations. The WOMAC is commonly used in clinical research to evaluate the efficacy of various treatments for osteoarthritis.
From enrollment day to the end of the rehabilitation program at 4 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain level; VAS score
Time Frame: From enrollment day to the end of the rehabilitation program at 4 weeks
The Visual Analog Scale (VAS) is a tool used to measure a patient's level of pain. It consists of a straight line with endpoints defining extreme limits such as 'no pain' and 'worst pain imaginable.' The patient marks on the line the point that they feel represents their perception of their current state. This method is simple, reliable, and widely used in both clinical and research settings to quantify pain intensity.
From enrollment day to the end of the rehabilitation program at 4 weeks
Timed Up and Go Test (TUG)
Time Frame: From enrollment day to the end of the rehabilitation program at 4 weeks
A rapid, standardized clinical tool used to measure a person's functional mobility, dynamic balance, and fall risk. It measures the time it takes for a person to get up from a chair, walk 3 meters (10 feet), turn around, walk back, and sit down again.
From enrollment day to the end of the rehabilitation program at 4 weeks
Stair Climbing Test (SCT)
Time Frame: From enrollment day to the end of the rehabilitation program at 4 weeks
The stair climbing test assesses lower body strength, functional capacity, and cardiopulmonary fitness by measuring how quickly you can safely climb and descend a flight of stairs. Versions are available with 3 to 12 steps; this study will use the 12-step version.
From enrollment day to the end of the rehabilitation program at 4 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Gazi University

Investigators

  • Principal Investigator: Levent Karatas, Gazi University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 2026

Primary Completion (Estimated)

September 1, 2027

Study Completion (Estimated)

September 15, 2027

Study Registration Dates

First Submitted

May 24, 2026

First Submitted That Met QC Criteria

May 24, 2026

First Posted (Actual)

June 1, 2026

Study Record Updates

Last Update Posted (Actual)

June 1, 2026

Last Update Submitted That Met QC Criteria

May 24, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Gonartroz -Tedavi Beklentisi

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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