Kneed is the first and only evidence-based online pain rehabilitation program developed specifically for people who continue to have pain after a knee replacement. Kneed will be launching here soon.
Kneed is an original self-management program designed and developed by Dr Nathan Johns as part of his PhD (Doctor of Philosophy), a postgraduate translational research program at Monash University in Melbourne, Australia.
The aim of Kneed is to reduce pain!
Our philosophy is that, if pain reduces, function, fitness and fullness of life follow.
This is achieved through a self-paced program (at your own time, however much you want) that teaches you why pain persists after knee replacement and teaches and shows you, what you need to do to improve. No one can do this for you, however, your family, friends and clinicians can support you in your recovery.
What’s in Kneed:
Kneed is designed as an 8 week pain rehabilitation program.
Kneed is divided into 4 pain knowledge modules, 5 pain training modules and 4 pain strategy modules that cover everything you Kneed to know to reduce your pain. With text, videos and quizzes, you will not only be provided with all the expert knowledge you need to improve, you will discover the motivation that gets you there.
By completing the modules you will understand why pain persists after knee replacement and be able to engage in exercise, movement training, brain training, desensitisation and relaxation and use strategies to manage flare-ups, relax with progressive muscular relaxation, sleep better and create a vision of the future by setting your own goals.
You can do the modules in any order you like, at your own pace, at any time over an 8 week period.
You can take notes as you go, be guided to develop your own exercise and activity programs and be guided to develop your own flare-up management program, all of which you can print or download to keep.
Kneed Modules
Pain education
There are four modules included in Kneed that help you improve your knowledge about why pain persists after a knee replacement.
Although why pain persists is complex, there are simpler ways to understand pain and how it can impact your movements, thoughts and activities.
Understanding why leads to knowing how you can reduce pain, improve function and get on with enjoying life.
People commonly take medication for pain and a module outlines the potential benefits and risks of taking medication to support discussions with your doctors.
Exercise
Don’t be left behind after your knee replacement!
Exercise not only reduces pain but improves health, balance, bone strength, sleep and mood.
Return to walking normally and improve your confidence to walk further and safely go up and down stairs.
Be active with any type of exercise you choose, with instructions on safe exercise, exercising when you have pain and the amount of exercise needed to benefit.
Included videos demonstrate stretches, improving walking patterns, balance exercises, strength and how to do steps.
Brain training
Do you see a left or right knee?
Persistent pain often leads to changes in how our brain functions and one such change can be illustrated by your ability to judge whether this is a left or right knee. (It is a left knee).
Why this occurs is explained in Kneed, with practice and training to try and fix it. This is combined with motor imagery training, another type of brain training that can help improve your knee movement patterns and reduce pain.
This module was very popular during the trial.
Desensitisation
Is your skin still sensitive and painful around your knee scar?
We have some tips on how to desensitise this area using touch, creams and gels as well as a tactile acuity training program to retrain sensation around your knee.
Relaxation
Pain often results in a stress on the body affecting the muscles, blood pressure, heart and breathing.
Pain also often results in stressful thoughts and feelings.
So, Kneed helps you to build your own relaxation program to help to you reduce your stress.
A progressive muscular relaxation audio program that teaches you how to control your breathing and relax your muscles is included.
Sleep
Having difficulty sleeping is a very common problem for people who have persistent pain.
Understanding how your pain experience is influenced by the qualty of your sleep provides you with another way to reduce you pain.
The sleep module will provide you with the low down on the lay down.
Managing flare-ups of pain
Sometimes, just when you think you are doing well and making some progress, you can be hit by a flare-up (or exacerbation) of pain. Knowing how to prevent and manage them is an important part of improving pain
Kneed teaches you how to prevent flare-ups.
Kneed also teaches you how to manage flare-ups with a novel formula that you can use everytime you need it.
Goal setting
If you don’t know where to start in your recovery, this module will guide you on how to set and achieve your personal goals.
This can include returning to your favourite activities, sports such as golf, gardening, exercise, domestic tasks or even self care.
Increasing functional activities
Many people report that they have difficulty returning to their enjoyable activities when they continue to have pain after their knee replacement.
This might include cooking, gardening, studying, socialising, working and more.
This module will teach you some strategies that aim to not only reduce pain, but also improve your ability to do your enjoyable activities.
More about the development of Kneed
As part of this PhD, Dr Johns reviewed all of the research that had been conducted in people with pain after knee replacement and authored articles investigating how much pain people have and for how long, the role of inpatient rehabilitation on knee pain and the role of rehabilitation in treating pain that persists after knee replacement.
Using the knowledge gained during the PhD, together with 20 years as a specialist rehabilitation physician treating people with pain after knee replacement and combining all the elements of neurological, cardiac and pain rehabilitation programs, Dr Johns designed, wrote and developed this website to provide the first pain rehabilitation program to treat people with persistent pain after knee replacement.
With his research team, Dr Johns conducted a randomised controlled trial to:
1. Assess feasibility (is it possible to recruit anyone to do Kneed and run the trial?)
2. Assess usability (is the website an ok way to receive healthcare information)
3. Assess whether Kneed improve pain, function, mood and quality of life
4. Assess whether participants in the trial feel that they are improved after doing the Kneed program
We recruited 60 people to the trial from Facebook and Instagram and were amazed by the number of people who were interested in the trial! A huge thank you to everyone who agreed to participate!
What we found:
Amazingly – 45% of people who joined the trial were for regional, rural or remote Australia. This was a fantastic result as equitable access to healthcare is part of our groups and the Australian digital healthcare strategy.
– 75% of the participants were female
– the average age was 68 years.
We will bring more results to you as soon as we publish!
