Meeus M.1,2, Diener I.3,4, Baert I.1, Lluch E.5
1University of Antwerp, Department of Rehabilitation Sciences and Physiotherapy, Wilrijk, Belgium, 2Ghent University, Department of Rehabilitation Sciecnes and Physiotherapy, Ghent, Belgium, 3Stellenbosch University, Stellenbosch, South Africa, 4University of the Western Cape, Stellenbosch, South Africa, 5University of Valencia, Department of Physical Therapy, Valencia, Spain
- Knowledge and understanding of the current biomechanical and pain neuroscience insights in OA (mainly knee and hip OA).
- Clinical reasoning and classification of patients with OA, taking into account both peripheral factors (biomechanical) and central factors (pain neuroscience).
- Balancing hands-on and hands-off treatment in patients with OA, according to their clinical classification.
Recent findings show that osteoarthritis (OA) is not always just a joint problem, as a dysfunction of the central nervous system may also be present. Traditional understanding of OA-related pain has recently indeed been challenged in light of evidence supporting a key role for central sensitization in a subgroup of this population1. This fact may erroneously lead physical therapists to conclude that hands-on interventions have no place in OA management, and that hands-off interventions must be applied exclusively2.
In this course we will teach how to integrate current biomechanical and pain neuroscience insights in OA in daily clinical practice.
We will unravel the interactions between muscles, joints and the central nervous system in OA and show the evidence for their role in OA prognosis 3,4,5.
Afterwards we will teach how both components (peripheral and central) can be assessed in clinical practice and how they can be approached during a comprehensive integrative treatment program, including education, exercise therapy and manual therapy2,6,7,8,9.
Recognition of subsets of OA patients with different clinical manifestations and pain mechanisms will be addressed in order to tailor applied interventions and thus improve outcome10. Depending on the subgroup classification of the patient a different balance between hands-on and hands-off treatment will be offered and the format of the exercise regimen will vary2,8.
Implications / Conclusions
The aim of this course is to present a sound scientific rationale and practical guidelines for the application of a comprehensive physical therapy approach in patients with OA-related pain. Clinicians may find some practical problems when combining biomechanical approaches with more brain targeted approaches in a clinical setting, especially in a specific population like OA, where patients are often a bit older and tend to stick with pure biomechanical illness perceptions in line with the earlier understanding of OA. We will provide a rationale and tips and tricks to target the brain without ignoring the joints in patients with OA.
- Chronic pain
Clinicians (physical, manual, exercise therapists) working in primary setting or in rehabilitation/geriatric centers or hospitals, treating patients with OA pain.
Level of learning
Programme subject to change