The effect of mindfulness and motivational interviewing along with neuromuscular exercises on pain, function, and balance of women affected by knee osteoarthritis: a rater-blinded randomized controlled clinical trial

Abstract

Purpose

This study aimed to evaluate the effect of motivational interviewing (MI) and mindfulness (MF) added to neuromuscular (NM) exercises on improving pain, function, balance, and quality of life in patients with knee osteoarthritis (KOA).

Methods

This randomized clinical trial was conducted on sixty patients who were randomly assigned to the MI + NM, MF + NM, and NM groups. The groups received four training sessions for six weeks. Physical function with Western Ontario and McMaster Universities Arthritis Index timed up and go, going up and down eight stairs, pain with visual analogue scale, quality of life with SF₃₆, and balance with Biodex were evaluated before and after interventions.

Results

Within-group comparisons showed that NM + MI, NM + MF, and NM groups experienced significant improvement in all factors after six-week (p < 0.05). However, between groups, comparisons in the post-test revealed that the MI + NM group had a more significant effect on pain, function, and static balance than the MF + NM group. Nevertheless, the MF + NM group improved the quality of life better than the MI + NM and NM groups (p < 0.05).

Conclusion

Adding psychological interventions to physical exercises had a better effect on improving the symptoms of patients. Additionally, the MI showed more effectiveness in improving the symptoms of patients.

IMPLICATIONS FOR REHABILITATION

• Adding motivational interviewing to neuromuscular exercises has shown to reduce pain intensity and improved function, balance and quality of life in adults with knee osteoarthritis.

• Adding mindfulness intervention to neuromuscular exercises has shown to reduce pain intensity and improved function, balance and quality of life in adults with knee osteoarthritis.

• Among the psychological interventions used, the motivational interviewing significantly showed more effectiveness in improving the pain, function, balance, and quality of life of patients with osteoarthritis.

Keywords:

• Knee osteoarthritis
• neuromuscular training
• mindfulness
• motivational interviewing
• performance
• chronic pain

Acknowledgments

The authors express their appreciation for the cooperation of rheumatology doctors, clinical psychologists, the participants of this study, who patiently completed all the stages of the research, and the head of the sports rehabilitation laboratory, who coordinated with the patients.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data are available on request from the authors.

Additional information

Funding

The Razi University supported this work.