345: Effect of Pain Science Education and Exercise on Disability in Older Adults with Knee Osteoarthritis

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic primary musculoskeletal pain, Physiotherapy (e.g. exercise, rehab)

Background and Aims: Introduction: Osteoarthritis is a degenerative joint disease that causes pain and stiffness, being prevalent in older adults. Knee osteoarthritis is one of the main causes of chronic pain and disability, significantly affecting quality of life. Pain neuroscience education (PNE) has emerged as a promising therapeutic approach, although evidence of its benefits in knee osteoarthritis is still lacking.
Objective: To determine whether a physical exercise program combined with PNE is more effective in reducing disability in people with knee osteoarthritis compared to an exercise-only program.

Methods: Methodology: A pilot randomized superiority clinical trial was conducted with women over 60 years old experiencing knee pain related to osteoarthritis, participants in the Camina 60+ program at Pontificia Universidad Católica de Chile. One group received PNE and exercise (IG, n=10), while the other received exercise only (EOG, n=9). Four variables were evaluated before and after 5 educational sessions of 30 minutes each: disability using the “Knee Injury and Osteoarthritis Outcome Score” (KOOS), pain using the Visual Analog Scale (VAS), functionality using the Sit to Stand Test (SST), and pain neuroscience knowledge using the Revised Neurophysiology of Pain Questionnaire (R-PNQ).

Results: Among the 19 participants, the IG showed a mean reduction trend of -1 point in VAS for pain intensity (p=0.6946). In the R-PNQ, the IG demonstrated significant improvement (mean: 2.5 points vs. 0.44 in the EOG; p=0.0101). Regarding SST, the IG showed significant functional improvement (mean: 2.5 repetitions vs. 0.89 in the EOG; p=0.0300). Finally, no significant differences were found between groups in the KOOS questionnaire for any evaluated dimension. However, improvements were observed in the symptoms category within the IG, with a trend toward improvement in other dimensions.

Conclusions: PNE sessions combined with physical exercise are not significantly better than an exercise-only program for reducing disability in older adults with knee osteoarthritis. Nonetheless, the IG showed significant improvements in functionality and pain knowledge compared to the control group.

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Presenting Author: Gustavo Torres R.
Submitting Author: Gustavo Torres

Senior Author: Gustavo Torres R.

IASP 2026 Global Year theme of Neuropathic Pain: No

• Magdalena Cozzi Conrads: PT - Pontificia Universidad Católica de Chile
• Sylvia Hernández Rebolledo: PT - Pontificia Universidad Católica de Chile
• Antonia Puelma Caro: PT - Pontificia Universidad Católica de Chile
• Diego Valenzuela Gonzalez: PT - Pontificia Universidad Católica de Chile
• Fernanda Calvo: PT, MSc - Pontificia Universidad Católica de Chile
• Ignacio Villagrán: PhD - Pontificia Universidad Católica de Chile
• Andres Flores: PhD - Pontificia Universidad Católica de Chile
• Francisca Rammsy: PT, MSc - Pontificia Universidad Católica de Chile