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Recent evidence suggests that knee osteoarthritis (KOA) chronic pain can result in brain structural and organizational changes. Thus, patients’ pain level, emotional status, and perception of their condition might be negatively altered. An approach to reverse such adaptations to chronic pain is cognitive behavioural therapy (CBT). Combining CBT with exercise might enhance therapy outcomes.

To identify the effect of combining exercise and CBT when delivered by a physical therapist in KOA pain.

A systematic search in PubMed, Cochrane, and Medline Complete (EBSCO) databases was conducted from their inception to March 2020, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study risk of bias and quality were assessed through the Risk-of-bias 2 (ROB2) and PEDro scales.

Six primary studies met eligibility criteria …