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Randomized Trial in knEe Osteoarthritis Using Low Intensity Ultrasound - Evaluating Feasibility (RELIEF) (RELIEF)

This study has been terminated.
(funding to support alternate feasible recruitment strategy was not acquired)
Bioventus LLC
Canadian Institutes of Health Research (CIHR)
Information provided by (Responsible Party):
McMaster University Identifier:
First received: May 31, 2012
Last updated: April 7, 2015
Last verified: April 2015
The purpose of this pilot study is to determine the feasibility of conducting a high quality clinical trial to investigate the effects of low intensity, pulsed ultrasound on knee osteoarthritis pain and physical function.

Condition Intervention
Knee Osteoarthritis Device: low intensity, pulsed ultrasound Device: sham ultrasound

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Can Very Low Intensity Ultrasound Therapy Improve Pain in People With Knee Osteoarthritis? A Pilot Randomized Controlled Trial

Resource links provided by NLM:

Further study details as provided by McMaster University:

Primary Outcome Measures:
  • Rate of recruitment [ Time Frame: 6 months ]
    Ability to recruit 30 participants over a 6 month period

  • Adherence to study protocol [ Time Frame: 26 weeks ]
    Percent adherence to the protocols for randomization, recruitment, intervention, and assessment

  • Rate of retention [ Time Frame: 26 weeks ]
    Number of participants completing the trial

  • Rate of all adverse events [ Time Frame: 26 weeks ]
    Participants will be asked about serious and non-serious adverse events weekly during the 13 week intervention phase and monthly during the 13 week follow up phase. All adverse events will be recorded and addressed as indicated.

Secondary Outcome Measures:
  • Western Ontario and McMaster Osteoarthritis Index (WOMAC)3.1NPR pain subscale [ Time Frame: 13 weeks ]
    Change from baseline in pain at 13 weeks

  • Western Ontario and McMaster Osteoarthritis Index (WOMAC)3.1NPR physical function subscale [ Time Frame: 26 weeks ]
    Change from baseline in Physical Function at 26 weeks

  • 6 Minute Walk Test (6MWT) [ Time Frame: 26 weeks ]
    Change from baseline distance (metres) walked in 6 minutes at 26 weeks

  • SF-36 (RAND 36-item Health Survey 1.0) [ Time Frame: 26 weeks ]
    Change from baseline in Health Related Quality of Life at 26 weeks

  • Global Rating of Disease Severity [ Time Frame: 26 weeks ]
    Change from baseline in Global Rating of Disease Severity at 13 and 26 weeks will be assessed using an 11-point scale ('Considering all the ways that your knee arthritis affects you, please rate how you are doing on a scale from 0 (very well) to 10 (very poor))

  • 11-point Verbal Numeric Rating Scale (VNRS) [ Time Frame: 0 and 13 weeks ]
    Change from baseline in pain intensity (average, minimum and maximum over the past 24 hours and following physical performance tests)

  • Lower Extremity Functional Scale (LEFS) [ Time Frame: 26 weeks ]
    Change from baseline in physical function at 26 weeks

  • Stair Climb test [ Time Frame: 26 weeks ]
    Time (seconds) to ascend and descend a staircase with 9 steps

  • Perceived change [ Time Frame: 13 and 26 weeks ]
    Perceived change from baseline will be assessed at 13 and 26 weeks using an 11-point scale ('With respect to your OA knee treated with ultrasound, how would you describe yourself now compared to baseline assessment?' -5 = a very great deal worse, 0 = about the same, +5 = a very great deal better)

Enrollment: 1
Study Start Date: July 2012
Study Completion Date: August 2014
Primary Completion Date: August 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Low intensity, pulsed ultrasound Device: low intensity, pulsed ultrasound
1.5MHz, spatial average-temporal average intensity = 0.03W/cm2, pulsed (burst frequency 1kHz, burst duration 200µm, duty cycle 20%); self-administered to the medial side of the knee joint while sitting down for 20 minutes every day for 3 months.
Other Name: Exogen Express Ultrasound Bone Healing System
Sham Comparator: Sham ultrasound Device: sham ultrasound
no ultrasonic energy emitted; self-administered to the medial side of the knee joint while sitting down for 20 minutes every day for 3 months
Other Name: sham Exogen Express Ultrasound Bone Healing System


Ages Eligible for Study:   40 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • over 40 years of age;
  • have medial tibiofemoral compartment knee OA;
  • have mild to moderate medial compartment radiographic OA severity (determined by the attending surgeon and/or Advanced Practice Physiotherapist on the basis of a standing x-ray or MRI scan depending upon which is available at initial consult);
  • have stable ('not getting worse or better overall despite short-term fluctuations during the past three months') pain having an average intensity ≥ 3 and ≤ 8 on an 11-point verbal numeric rating scale, VNRS) in one knee which is aggravated by activity and eased with rest;
  • limited pain from other lower extremity joints; and
  • no change in first line pain medication in the past 2 months and willingness to forego alterations in pain medication for the duration of the study unless deemed medically necessary.

Exclusion Criteria:

  • history of traumatic OA or previous surgical intervention in the knee or knee effusion;
  • intra-articular injection of the knee in the previous 6 months;
  • received ultrasound treatment for knee OA within the past 6 months;
  • body weight changed ≥ 5% in the past 2 months;
  • level of physical function insufficient to perform the required assessments or administer the intervention (e.g. intermittent claudication, severe peripheral neuropathy, active proliferative retinopathy, unstable cardiac or pulmonary disease, disabling stroke, chronic pain, arthritis in joints other than the study knee, bone fracture in the past 3 months);
  • conditions listed as precautions or unknown safety risks for using the EXOGEN EXPRESS ultrasound device (pregnant or nursing women, individuals with thrombophlebitis, vascular insufficiency, abnormal skin sensitivity, sensory paralysis, open wound at the medial joint line of the knee, taking steroids/anti-coagulants, prescription non-steroidal anti-inflammatory, calcium channel blocker or applying the EXOGEN EXPRESS in close proximity to someone wearing a cardiac pacemaker);
  • unable to read, write and/or understand English;
  • other illness or reasons judged by the participant, clinicians or researchers to make participation inadvisable (e.g. plans to move or travel, cognitive deficit resulting in difficulty comprehending and complying with instructions, caregiving demands/lack of social support for participation);
  • unwillingness to sign informed consent; or
  • participation in a competing study.
  Contacts and Locations
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Please refer to this study by its identifier: NCT01623804

Canada, Ontario
Regional Joint Assessment Program - HHS/SJHH
Hamilton, Ontario, Canada, L8S 1C7
Sponsors and Collaborators
McMaster University
Bioventus LLC
Canadian Institutes of Health Research (CIHR)
Principal Investigator: Norma J MacIntyre, PT, PhD McMaster University
  More Information

Responsible Party: McMaster University Identifier: NCT01623804     History of Changes
Other Study ID Numbers: EX-KOA-1206
EX-KOA-xxxxxx ( Other Grant/Funding Number: Smith & Nephew, Inc )
MTP 108229/MTO 108232 ( Other Grant/Funding Number: Canadian Institutes of Health Research )
Study First Received: May 31, 2012
Last Updated: April 7, 2015

Keywords provided by McMaster University:
Ultrasound therapy
Tibiofemoral joint, medial

Additional relevant MeSH terms:
Osteoarthritis, Knee
Joint Diseases
Musculoskeletal Diseases
Rheumatic Diseases processed this record on August 18, 2017