Gonarthrosis; PrimaryNCT07618403
Physical Therapy Program and Treatment Expectations in Knee Osteoarthritis
An observational study of Gonarthrosis; Primary and Physical Therapy, run by Gazi University at 1 site in Turkey (Türkiye).
Trial summary
To our knowledge, no studies have been conducted in the literature investigating the relationship between the success of physical therapy programs applied in knee osteoarthritis and patients' pre-treatment expectations. Read more about this study
- Who is it for?
- Ages 50 years and older
- Conditions the study is for
- Gonarthrosis; Primary, Physical Therapy, Patients' Expectations
- What is being tested?
- Physical Therapy
- How many people
- 84 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 1 Jan 2026to 15 Sep 2027
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 50 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Patients aged 50 years and older who present with knee pain and are found to have grade 2 or higher gonarthrosis according to the Kellgren-Lawrence classification on X-ray imaging.
Who may be able to join
- Agreeing to participate in the study
- Being over 50 years of age
- Having a clinically and radiographically confirmed diagnosis of knee osteoarthritis
- Having grade 2-3-4 knee osteoarthritis according to the Kellgren-Lawrence grading system
- Being literate
Who cannot join
- Previous knee surgery
- Conditions that prevent exercise (such as incurable malignancy, active systemic infection, non-union fracture)
- Presence of accompanying neurological disease affecting the lower extremity
- Severe cognitive impairment (neuropsychiatric disease or condition that will impede cooperation, such as psychosis, dementia)
- History of having received injections or other procedures to the knee joint or physical therapy within the last 6 months
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Levent Karatas contact
Turkey (Türkiye)1 site, 1 recruiting
- Recruiting
Gazi University
Ankara, Yenimahalle, 06170
Levent Karatas, Doc, +90 505 562 94 37, dr.levent.karatas@gmail.com
About this study
Official title: Evaluating The Predictive Effect of Treatment Expectations on Response to A Physical Therapy Program in Patients With Knee Osteoarthritis
To our knowledge, no studies have been conducted in the literature investigating the relationship between the success of physical therapy programs applied in knee osteoarthritis and patients' pre-treatment expectations. The rationale for this study is to demonstrate the possible relationship between treatment expectations and the benefits seen from conventional physical therapy programs in patients with knee osteoarthritis, and to provide clinicians with a different perspective in knee osteoarthritis treatment planning.
Read the detailed description
Osteoarthritis, also called degenerative joint disease, primarily occurs in old age, but can also develop after trauma or secondarily to diseases such as rheumatoid arthritis and hemochromatosis. Osteoarthritis is the most common joint disease worldwide. The pathophysiology of osteoarthritis is responsible for the failed repair of joint damage caused by stress initiated by any joint or periarticular tissue abnormality. The most common symptom of osteoarthritis is pain. Factors associated with an increased risk of knee osteoarthritis include advanced age, family history, overweight or obesity, a history of knee trauma, occupational factors, and varus or valgus alignment. Long-term complications of osteoarthritis include decreased physical activity, loss of fitness, sleep disturbances, fatigue, and depression. With the increasing aging population, degenerative joint problems have become a concern for a large part of society. Exercise is a key component in the treatment of this chronic disease, which restricts functionality and reduces quality of life. A systematic review of 54 randomized controlled trials involving a total of 5362 participants showed that different types of exercise improved pain, functionality, and quality of life in knee osteoarthritis. Studies have shown that treatment outcomes are not always similar in patients undergoing similar treatment programs, and that patients' expectations from treatment can also influence results. A systematic literature review on improvement expectations revealed that in 15 out of 16 studies, positive patient expectations were associated with better health outcomes. A recent study in the field of physical therapy also showed that in the treatment of chronic low back pain, high patient expectations were associated with the success of the treatment. Therefore, we planned this study to answer the questions of whether treatment expectations have a predictive effect on the benefits seen from an exercise program in patients with knee osteoarthritis, and whether it is necessary to evaluate the level of expectations when creating a treatment program for patients with knee osteoarthritis.
- Being tested
- Physical Therapy
- Keywords
- treatment expectations, gonarthrosis, physical treatment
- Medical subject headings
- Osteoarthritis, Knee
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Physical TherapyOther
Patients in both groups will receive 15 sessions of a conventional physical therapy program.
| Study group | Role | What they receive |
|---|---|---|
| Those with Low Treatment Expectations | Using the Turkish version of the Treatment Expectation Questionnaire (TEX-Q)(English version is provided in the documents section), patients will be divided into two groups: those with low expectations and those with high expectations. Receives: Other: Physical Therapy | |
| Those with High Treatment Expectations | Using the Turkish version of the Treatment Expectation Questionnaire (TEX-Q)(English version is provided in the documents section), patients will be divided into two groups: those with low expectations and those with high expectations. Receives: Other: Physical Therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
The Western Ontario and McMaster Universities Arthritis Index (WOMAC) score
WOMAC score evaluation following the last treatment session. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is a widely used, validated questionnaire designed to assess pain, stiffness, and physical function in patients with knee and hip osteoarthritis. It consists of 24 items divided into three subscales: pain (5 items), stiffness (2 items), and physical function (17 items). Patients rate their symptoms on a Likert scale, with higher scores indicating worse pain, stiffness, or functional limitations. The WOMAC is commonly used in clinical research to evaluate the efficacy of various treatments for osteoarthritis.
Measured: From enrollment day to the end of the rehabilitation program at 4 weeks
Secondary outcomes (3)
Pain level; VAS score
The Visual Analog Scale (VAS) is a tool used to measure a patient's level of pain. It consists of a straight line with endpoints defining extreme limits such as 'no pain' and 'worst pain imaginable.' The patient marks on the line the point that they feel represents their perception of their current state. This method is simple, reliable, and widely used in both clinical and research settings to quantify pain intensity.
Measured: From enrollment day to the end of the rehabilitation program at 4 weeks
Timed Up and Go Test (TUG)
A rapid, standardized clinical tool used to measure a person's functional mobility, dynamic balance, and fall risk. It measures the time it takes for a person to get up from a chair, walk 3 meters (10 feet), turn around, walk back, and sit down again.
Measured: From enrollment day to the end of the rehabilitation program at 4 weeks
Stair Climbing Test (SCT)
The stair climbing test assesses lower body strength, functional capacity, and cardiopulmonary fitness by measuring how quickly you can safely climb and descend a flight of stairs. Versions are available with 3 to 12 steps; this study will use the 12-step version.
Measured: From enrollment day to the end of the rehabilitation program at 4 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted1 Jun 2026
- Study start1 Jan 2026
- Primary completion1 Sep 2027 (estimated)
- Study completion15 Sep 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (9)Papers the sponsor has linked to this study.
- Other trials for Gonarthrosis; PrimaryStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 84 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Gazi University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Levent Karataş, Gazi University
- Investigators
- Levent Karatas, Principal investigator, Gazi University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07618403
- Sponsor's protocol ID
- Gonartroz -Tedavi Beklentisi
- Status last verified
- Jun 2026
- First submitted
- 24 May 2026
- Last updated
- 10 Jun 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Fransen M, McConnell S, Harmer AR, Van der Esch M, Simic M, Bennell KL. Exercise for osteoarthritis of the knee: a Cochrane systematic review. Br J Sports Med. 2015 Dec;49(24):1554-7. doi: 10.1136/bjsports-2015-095424. Epub 2015 Sep 24.
PubMed 26405113Mondloch MV, Cole DC, Frank JW. Does how you do depend on how you think you'll do? A systematic review of the evidence for a relation between patients' recovery expectations and health outcomes. CMAJ. 2001 Jul 24;165(2):174-9.
PubMed 11501456Levenig CG, Hasenbring MI, Gunnewig L, Titze C, Elsenbruch S, Schulte TL. Treatment Expectations-You Get What You Expect-and Depression Plays a Role. J Pain. 2024 Sep;25(9):104582. doi: 10.1016/j.jpain.2024.104582. Epub 2024 May 29.
PubMed 38821312Myers SS, Phillips RS, Davis RB, Cherkin DC, Legedza A, Kaptchuk TJ, Hrbek A, Buring JE, Post D, Connelly MT, Eisenberg DM. Patient expectations as predictors of outcome in patients with acute low back pain. J Gen Intern Med. 2008 Feb;23(2):148-53. doi: 10.1007/s11606-007-0460-5. Epub 2007 Dec 8.
PubMed 18066631Robinson ME, Brown JL, George SZ, Edwards PS, Atchison JW, Hirsh AT, Waxenberg LB, Wittmer V, Fillingim RB. Multidimensional success criteria and expectations for treatment of chronic pain: the patient perspective. Pain Med. 2005 Sep-Oct;6(5):336-45. doi: 10.1111/j.1526-4637.2005.00059.x.
PubMed 16266354Abdel-Aziz MA, Ahmed HMS, El-Nekeety AA, Abdel-Wahhab MA. Osteoarthritis complications and the recent therapeutic approaches. Inflammopharmacology. 2021 Dec;29(6):1653-1667. doi: 10.1007/s10787-021-00888-7. Epub 2021 Nov 9.
PubMed 34755232Lespasio MJ, Piuzzi NS, Husni ME, Muschler GF, Guarino A, Mont MA. Knee Osteoarthritis: A Primer. Perm J. 2017;21:16-183. doi: 10.7812/TPP/16-183.
PubMed 29035179Jang S, Lee K, Ju JH. Recent Updates of Diagnosis, Pathophysiology, and Treatment on Osteoarthritis of the Knee. Int J Mol Sci. 2021 Mar 5;22(5):2619. doi: 10.3390/ijms22052619.
PubMed 33807695Hsu H, Siwiec RM. Knee Osteoarthritis. 2023 Jun 26. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK507884/
PubMed 29939661
Study at a glance
From the registry record, last updated by the sponsor on 10 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Evaluating The Predictive Effect of Treatment Expectations on Response to A Physical Therapy Program in Patients With Knee Osteoarthritis
- ClinicalTrials.gov ID
- NCT07618403
- Acronym / sponsor ID
- Gonartroz -Tedavi Beklentisi
- Keywords
- treatment expectations, gonarthrosis, physical treatment
- Study type
- Observational
- Recruitment status
- Recruiting
- Enrolment
- 84 participants (estimated)
- Lead sponsor
- Gazi UniversityUniversity, hospital or other
- Study start
- 1 Jan 2026 (actual)
- Primary completion
- 1 Sep 2027 (estimated)
- Study completion
- 15 Sep 2027 (estimated)
- First posted
- 1 Jun 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
To our knowledge, no studies have been conducted in the literature investigating the relationship between the success of physical therapy programs applied in knee osteoarthritis and patients' pre-treatment expectations. The rationale for this study is to demonstrate the possible relationship between treatment expectations and the benefits seen from conventional physical therapy programs in patients with knee osteoarthritis, and to provide clinicians with a different perspective in knee osteoarthritis treatment planning.
Detailed description
Osteoarthritis, also called degenerative joint disease, primarily occurs in old age, but can also develop after trauma or secondarily to diseases such as rheumatoid arthritis and hemochromatosis. Osteoarthritis is the most common joint disease worldwide. The pathophysiology of osteoarthritis is responsible for the failed repair of joint damage caused by stress initiated by any joint or periarticular tissue abnormality. The most common symptom of osteoarthritis is pain. Factors associated with an increased risk of knee osteoarthritis include advanced age, family history, overweight or obesity, a history of knee trauma, occupational factors, and varus or valgus alignment. Long-term complications of osteoarthritis include decreased physical activity, loss of fitness, sleep disturbances, fatigue, and depression. With the increasing aging population, degenerative joint problems have become a concern for a large part of society. Exercise is a key component in the treatment of this chronic disease, which restricts functionality and reduces quality of life. A systematic review of 54 randomized controlled trials involving a total of 5362 participants showed that different types of exercise improved pain, functionality, and quality of life in knee osteoarthritis. Studies have shown that treatment outcomes are not always similar in patients undergoing similar treatment programs, and that patients' expectations from treatment can also influence results. A systematic literature review on improvement expectations revealed that in 15 out of 16 studies, positive patient expectations were associated with better health outcomes. A recent study in the field of physical therapy also showed that in the treatment of chronic low back pain, high patient expectations were associated with the success of the treatment. Therefore, we planned this study to answer the questions of whether treatment expectations have a predictive effect on the benefits seen from an exercise program in patients with knee osteoarthritis, and whether it is necessary to evaluate the level of expectations when creating a treatment program for patients with knee osteoarthritis.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Those with Low Treatment Expectations | – | Other: Physical TherapyUsing the Turkish version of the Treatment Expectation Questionnaire (TEX-Q)(English version is provided in the documents section), patients will be divided into two groups: those with low expectations and those with high expectations. |
| Those with High Treatment Expectations | – | Other: Physical TherapyUsing the Turkish version of the Treatment Expectation Questionnaire (TEX-Q)(English version is provided in the documents section), patients will be divided into two groups: those with low expectations and those with high expectations. |
Who may qualify
- Ages
- 50 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Patients aged 50 years and older who present with knee pain and are found to have grade 2 or higher gonarthrosis according to the Kellgren-Lawrence classification on X-ray imaging.
Key inclusion criteria (5 listed)
- Agreeing to participate in the study
- Being over 50 years of age
- Having a clinically and radiographically confirmed diagnosis of knee osteoarthritis
- Having grade 2-3-4 knee osteoarthritis according to the Kellgren-Lawrence grading system
- Being literate
Key exclusion criteria (5 listed)
- Previous knee surgery
- Conditions that prevent exercise (such as incurable malignancy, active systemic infection, non-union fracture)
- Presence of accompanying neurological disease affecting the lower extremity
- Severe cognitive impairment (neuropsychiatric disease or condition that will impede cooperation, such as psychosis, dementia)
- History of having received injections or other procedures to the knee joint or physical therapy within the last 6 months
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Physical TherapyPatients in both groups will receive 15 sessions of a conventional physical therapy program. | Other | Those with High Treatment Expectations, Those with Low Treatment Expectations |
Primary outcome
The Western Ontario and McMaster Universities Arthritis Index (WOMAC) score
Time frame: From enrollment day to the end of the rehabilitation program at 4 weeks
WOMAC score evaluation following the last treatment session. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is a widely used, validated questionnaire designed to assess pain, stiffness, and physical function in patients with knee and hip osteoarthritis. It consists of 24 items divided into three subscales: pain (5 items), stiffness (2 items), and physical function (17 items). Patients rate their symptoms on a Likert scale, with higher scores indicating worse pain, stiffness, or functional limitations. The WOMAC is commonly used in clinical research to evaluate the efficacy of various treatments for osteoarthritis.
3 secondary outcomes
Pain level; VAS score
Time frame: From enrollment day to the end of the rehabilitation program at 4 weeks
Timed Up and Go Test (TUG)
Time frame: From enrollment day to the end of the rehabilitation program at 4 weeks
Stair Climbing Test (SCT)
Time frame: From enrollment day to the end of the rehabilitation program at 4 weeks
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Jun 2026.
- Background: PubMed 26405113Fransen M, McConnell S, Harmer AR, Van der Esch M, Simic M, Bennell KL. Exercise for osteoarthritis of the knee: a Cochrane systematic review. Br J Sports Med. 2015 Dec;49(24):1554-7. doi: 10.1136/bjsports-2015-095424. Epub 2015 Sep 24.
- Background: PubMed 11501456Mondloch MV, Cole DC, Frank JW. Does how you do depend on how you think you'll do? A systematic review of the evidence for a relation between patients' recovery expectations and health outcomes. CMAJ. 2001 Jul 24;165(2):174-9.
- Background: PubMed 38821312Levenig CG, Hasenbring MI, Gunnewig L, Titze C, Elsenbruch S, Schulte TL. Treatment Expectations-You Get What You Expect-and Depression Plays a Role. J Pain. 2024 Sep;25(9):104582. doi: 10.1016/j.jpain.2024.104582. Epub 2024 May 29.
- Background: PubMed 18066631Myers SS, Phillips RS, Davis RB, Cherkin DC, Legedza A, Kaptchuk TJ, Hrbek A, Buring JE, Post D, Connelly MT, Eisenberg DM. Patient expectations as predictors of outcome in patients with acute low back pain. J Gen Intern Med. 2008 Feb;23(2):148-53. doi: 10.1007/s11606-007-0460-5. Epub 2007 Dec 8.
- Background: PubMed 16266354Robinson ME, Brown JL, George SZ, Edwards PS, Atchison JW, Hirsh AT, Waxenberg LB, Wittmer V, Fillingim RB. Multidimensional success criteria and expectations for treatment of chronic pain: the patient perspective. Pain Med. 2005 Sep-Oct;6(5):336-45. doi: 10.1111/j.1526-4637.2005.00059.x.
- Background: PubMed 34755232Abdel-Aziz MA, Ahmed HMS, El-Nekeety AA, Abdel-Wahhab MA. Osteoarthritis complications and the recent therapeutic approaches. Inflammopharmacology. 2021 Dec;29(6):1653-1667. doi: 10.1007/s10787-021-00888-7. Epub 2021 Nov 9.
- Background: PubMed 29035179Lespasio MJ, Piuzzi NS, Husni ME, Muschler GF, Guarino A, Mont MA. Knee Osteoarthritis: A Primer. Perm J. 2017;21:16-183. doi: 10.7812/TPP/16-183.
- Background: PubMed 33807695Jang S, Lee K, Ju JH. Recent Updates of Diagnosis, Pathophysiology, and Treatment on Osteoarthritis of the Knee. Int J Mol Sci. 2021 Mar 5;22(5):2619. doi: 10.3390/ijms22052619.
- Background: PubMed 29939661Hsu H, Siwiec RM. Knee Osteoarthritis. 2023 Jun 26. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK507884/
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Levent Karatas contact
Levent Karatas principal investigator
Gazi University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Gonarthrosis; Primary and Physical Therapy, run by Gazi University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 10 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Burak Tokac (+905313474837, buraktokac96@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
The Western Ontario and McMaster Universities Arthritis Index (WOMAC) score (time frame: From enrollment day to the end of the rehabilitation program at 4 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07618403, which also lists 9 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Jun 2026.