{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T17:32:28Z","timestamp":1775928748331,"version":"3.50.1"},"reference-count":44,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T00:00:00Z","timestamp":1700092800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009128","name":"Research for Patient Benefit Programme","doi-asserted-by":"publisher","award":["NIHR202203"],"award-info":[{"award-number":["NIHR202203"]}],"id":[{"id":"10.13039\/501100009128","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Musculoskeletal Care"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cognitive Muscular TherapyTM (CMT) is an integrated behavioural intervention developed for knee osteoarthritis. CMT teaches patients to reconceptualise the condition, integrates muscle biofeedback and aims to reduce muscle overactivity, both in response to pain and during daily activities. This nested qualitative study explored patient and physiotherapist perspectives and experiences of CMT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Five physiotherapists were trained to follow a well\u2010defined protocol and then delivered CMT to at least two patients with knee osteoarthritis. Each patient received seven individual clinical sessions and was provided with access to online learning materials incorporating animated videos. Semi\u2010structured interviews took place after delivery\/completion of the intervention and data were analysed at the patient and physiotherapist level.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five physiotherapists and five patients were interviewed. All described a process of changing beliefs throughout their engagement with CMT. A framework with three phases was developed to organise the data according to how osteoarthritis was conceptualised and how this changed throughout their interactions with CMT. Firstly, was an identification of pain beliefs to be challenged and recognition of how current beliefs can misalign with daily experiences. Secondly was a process of challenging and changing beliefs, validated through new experiences. Finally, there was an embedding of changed beliefs into self\u2010management to continue with activities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study identified a range of psychological changes which occur during exposure to CMT. These changes enabled patients to reconceptualise their condition, develop a new understanding of their body, understand psychological processes, and make sense of their knee pain.<\/jats:p><\/jats:sec>","DOI":"10.1002\/msc.1842","type":"journal-article","created":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T12:43:57Z","timestamp":1700138637000},"page":"1639-1650","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["From sceptic to believer: Acceptability of cognitive muscular therapy<sup>TM<\/sup>, a new intervention for knee osteoarthritis"],"prefix":"10.1002","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0580-0205","authenticated-orcid":false,"given":"Daniela","family":"Ghio","sequence":"first","affiliation":[{"name":"Division of Psychology and Mental Health Faculty of Biology School of Health Sciences Medicine and Health University of Manchester  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan","family":"Brookes","sequence":"additional","affiliation":[{"name":"School of Health and Society Health Sciences University of Salford  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Preece","sequence":"additional","affiliation":[{"name":"School of Health and Society Health Sciences University of Salford  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Walsh","sequence":"additional","affiliation":[{"name":"Centre for Health and Clinical Research University of the West of England  Bristol UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,11,16]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"21","article-title":"The role of psychological skills within physiotherapy: A narrative review of the profession and training","author":"Alexanders J.","year":"2017","journal-title":"Physical Therapy Reviews"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.physio.2014.03.008"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2015.10.021"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis\u20102021\u2010221129"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22744"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2014.01.038"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/2159676x.2019.1628806"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/corr.0000000000000784"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20160211"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports\u20102019\u2010101328"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjhp.12080"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2016.1223176"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.cd004376.pub3"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(14)60802\u20103"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rehab.2019.04.006"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2008.07.014"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2009.08.005"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00221\u2010015\u20104347\u20100"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2010.10.020"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.math.2015.07.004"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelekin.2005.07.014"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2012.07.008"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(19)30417\u20109"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20642"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22052619"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2006.12.007"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461\u2010016\u20101611\u20107"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/msc.1620"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2021.05.007"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelekin.2010.05.005"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732315617444"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1526\u20105900(03)00488\u20107"},{"key":"e_1_2_11_34_1","unstructured":"NICE. (2022). National Institute for Health and Care Excellence [NICE] (2022) Retrieved fromhttps:\/\/www.nice.org.uk\/guidance\/ng226"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2021.11.008"},{"key":"e_1_2_11_36_1","first-page":"31","volume-title":"A new behavioural intervention for knee osteoarthritis","author":"Preece S. J.","year":"2023"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891\u2010021\u201004389\u20100"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891\u2010016\u20101209\u20102"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2020.12.024"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2022.789377"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0005\u20107967(00)00061\u20109"},{"key":"e_1_2_11_42_1","first-page":"e89","article-title":"PEER umbrella systematic review of systematic reviews: Management of osteoarthritis in primary care","volume":"66","author":"Ton J.","year":"2020","journal-title":"Canadian Family Physician"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2011.12.009"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102019\u2010030060"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1080\/13548506.2017.1282160"}],"container-title":["Musculoskeletal Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/msc.1842","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T15:27:31Z","timestamp":1703604451000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/msc.1842"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,16]]},"references-count":44,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1002\/msc.1842"],"URL":"https:\/\/doi.org\/10.1002\/msc.1842","archive":["Portico"],"relation":{},"ISSN":["1478-2189","1557-0681"],"issn-type":[{"value":"1478-2189","type":"print"},{"value":"1557-0681","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,16]]},"assertion":[{"value":"2023-10-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}