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The KOMPACT-P study: Knee Osteoarthritis Management with Physiotherapy informed by Acceptance and Commitment
Marie K March1,2, Alison Harmer2, Emma Godfrey3,4
1Physiotherapy Department, Blacktown Mt Druitt Hospital, Western Sydney Local Health District, Blacktown, New South Wales, Australia Marie.March@health.nsw.gov.au.
BMJ Open
|June 6, 2020
Summary
This pilot study explored the Knee Osteoarthritis Management with Physiotherapy informed by Acceptance and Commitment Therapy (KOMPACT) approach for patients awaiting total knee arthroplasty (TKA). KOMPACT appears safe, acceptable, and feasible for this population.
Area of Science:
- Orthopedics and Rehabilitation
- Psychological Interventions in Musculoskeletal Conditions
Background:
- Total knee arthroplasty (TKA) incidence is rising, with psychological distress impacting up to 42% of patients and affecting postoperative outcomes.
- Existing psychological treatments for TKA patients are limited and typically delivered by psychologists.
- There is a lack of evidence for psychologically-informed interventions delivered by healthcare professionals within TKA clinical pathways.
Purpose of the Study:
- To explore the safety, acceptability, and feasibility of a novel intervention for patients awaiting TKA.
- To evaluate the Knee Osteoarthritis Management with Physiotherapy informed by Acceptance and Commitment Therapy (KOMPACT) approach.
- To assess the potential of integrating psychological support into TKA care pathways.
Main Methods:
- A pilot, mixed-methods, prospective randomized controlled trial involving 51 adults scheduled for primary TKA.
- Participants were randomized 1:2 to usual care or usual care plus KOMPACT (physiotherapy informed by Acceptance and Commitment Therapy).
- Primary outcomes included safety, acceptability, and feasibility; secondary outcomes covered health service, patient-reported, and physical performance measures.
Main Results:
- The KOMPACT intervention was assessed for safety (length of stay, complications, psychological health).
- Acceptability was measured through treatment credibility and qualitative feedback.
- Feasibility was determined by recruitment, retention, and intervention fidelity rates.
Conclusions:
- The KOMPACT approach demonstrated potential as a safe, acceptable, and feasible intervention for individuals awaiting TKA.
- This pilot study provides a foundation for further research into psychologically-informed physiotherapy for TKA patients.
- Findings support the integration of such interventions into standard TKA clinical pathways.
