Physiotherapists' Experiences and Perceived Acceptability of Delivering a Knee Bracing Intervention for People With Symptomatic Knee Osteoarthritis in a Randomised Trial (PROP OA): A Qualitative Study

Laurna Bullock^{1

2}, Melanie A Holden^{1

2}, Clare Jinks^{1

2}, Evans Atiah Asamane³, Dan Herron⁴, Belinda Borrelli^{5

6}, Michael J Callaghan^{7

8

9}, Fraser Birrell^{10

11}, Nicola Halliday^{1

12}, Michelle Marshall^{1

2}, Gail Sowden¹³, Carol Ingram¹⁴, John McBeth¹⁵, Krysia Dziedzic^{1

2

16}, Nadine E Foster^{1

17}, Sue Jowett^{1

18}, Sarah Lawton^{1

12}, Christian D Mallen^{1

2}, George Peat^{1

19}

Affiliations

¹ School of Medicine, Primary Care Centre Versus Arthritis, Keele University, Keele, UK.
² Centre for Musculoskeletal Research, Keele University, Keele, UK.
³ Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
⁴ Department of Psychology, School of Health, Education, Policing and Sciences, Staffordshire University, Stoke-on-Trent, UK.
⁵ Henry M Goldman School of Dental Medicine, Boston University, Boston, Massachusetts, USA.
⁶ Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
⁷ Centre for Musculoskeletal Research, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK.
⁸ Faculty of Health and Education, Manchester Metropolitan University Manchester, Manchester, UK.
⁹ Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
¹⁰ MRC-Versus Arthritis Centre for Integrated Research Into Musculoskeletal Ageing, Newcastle University, Newcastle upon Tyne, UK.
¹¹ Northumbria Healthcare NHS Foundation Trust, North Tyneside, UK.
¹² Keele Clinical Trials Unit, Keele University, Keele, UK.
¹³ Connect Health, Newcastle Upon Tyne, UK.
¹⁴ Research User Group, Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK.
¹⁵ School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK.
¹⁶ Impact Accelerator Unit, Keele University, Keele, UK.
¹⁷ Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Brisbane, Australia.
¹⁸ Health Economics Unit, Department of Applied Health Research, School of Health Sciences, University of Birmingham, Birmingham, UK.
¹⁹ Centre for Applied Health & Social Care Research (CARe), Sheffield Hallam University, Sheffield, UK.

PMID: 39694859
PMCID: PMC11655417
DOI: 10.1002/msc.70021

Randomized Controlled Trial

Physiotherapists' Experiences and Perceived Acceptability of Delivering a Knee Bracing Intervention for People With Symptomatic Knee Osteoarthritis in a Randomised Trial (PROP OA): A Qualitative Study

Laurna Bullock et al. Musculoskeletal Care. 2024 Dec.

. 2024 Dec;22(4):e70021.

doi: 10.1002/msc.70021.

Authors

Affiliations

¹ School of Medicine, Primary Care Centre Versus Arthritis, Keele University, Keele, UK.
² Centre for Musculoskeletal Research, Keele University, Keele, UK.
³ Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
⁴ Department of Psychology, School of Health, Education, Policing and Sciences, Staffordshire University, Stoke-on-Trent, UK.
⁵ Henry M Goldman School of Dental Medicine, Boston University, Boston, Massachusetts, USA.
⁶ Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
⁷ Centre for Musculoskeletal Research, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK.
⁸ Faculty of Health and Education, Manchester Metropolitan University Manchester, Manchester, UK.
⁹ Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
¹⁰ MRC-Versus Arthritis Centre for Integrated Research Into Musculoskeletal Ageing, Newcastle University, Newcastle upon Tyne, UK.
¹¹ Northumbria Healthcare NHS Foundation Trust, North Tyneside, UK.
¹² Keele Clinical Trials Unit, Keele University, Keele, UK.
¹³ Connect Health, Newcastle Upon Tyne, UK.
¹⁴ Research User Group, Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK.
¹⁵ School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK.
¹⁶ Impact Accelerator Unit, Keele University, Keele, UK.
¹⁷ Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Brisbane, Australia.
¹⁸ Health Economics Unit, Department of Applied Health Research, School of Health Sciences, University of Birmingham, Birmingham, UK.
¹⁹ Centre for Applied Health & Social Care Research (CARe), Sheffield Hallam University, Sheffield, UK.

PMID: 39694859
PMCID: PMC11655417
DOI: 10.1002/msc.70021

Abstract

Objectives: To explore physiotherapists' experiences and perceived acceptability of delivering a bracing intervention for knee osteoarthritis (OA) in the 'PROvision of braces for Patients with knee OA' (PROP OA) randomised controlled trial.

Method: Semi-structured telephone interviews with consenting physiotherapists who received the PROP OA training programme and delivered the knee bracing intervention (advice, information and exercise instruction plus knee brace matched to patients' clinical and radiographic presentation and with adherence support). Interviews were recorded and transcribed verbatim. Two-stage analytic framework: inductive thematic analysis preceded mapping to constructs of the Theoretical Framework of Acceptability.

Results: Eight physiotherapists were interviewed and six key themes were developed. Perceptions of the training programme were generally positive, but additional formal training and experiential learning consolidated confidence and skills in novel intervention components. Advice, information, and exercise instruction reflected usual physiotherapy care for knee OA. Physiotherapists were confident in delivering the knee brace, but determining the pattern of knee OA to inform brace type selection was challenging. Physiotherapists valued brace adherence enhancing strategies and the follow-up appointment to facilitate adherence. Perceived impact of the bracing intervention for people with OA was positive. The bracing intervention was perceived as acceptable, although improving self-efficacy to deliver novel intervention components (e.g., reading x-rays) would enhance acceptability.

Conclusion: The complex knee bracing intervention was broadly perceived as acceptable by physiotherapists. If implemented within clinical practice beyond the trial, physiotherapists might benefit from not only initial training in brace selection but also ongoing support and mentoring to increase self-efficacy in delivery.

Keywords: bracing; knee; osteoarthritis; physiotherapy; qualitative; randomised controlled trial.

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Conflict of interest statement

CDM is director of the National Institute for Health and Care Research School for Primary Care Research (SPCR). All other authors declare no conflicts of interest.

References

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Physiotherapists' Experiences and Perceived Acceptability of Delivering a Knee Bracing Intervention for People With Symptomatic Knee Osteoarthritis in a Randomised Trial (PROP OA): A Qualitative Study

Affiliations

Physiotherapists' Experiences and Perceived Acceptability of Delivering a Knee Bracing Intervention for People With Symptomatic Knee Osteoarthritis in a Randomised Trial (PROP OA): A Qualitative Study

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources