Article

Efficacy of physiotherapy management of knee joint osteoarthritis: a randomised, double blind, placebo controlled trial

Centre for Health, Exercise and Sports Medicine, School of Physiotherapy, University of Melbourne, Parkville, Victoria 3010, Australia.
Annals of the Rheumatic Diseases (Impact Factor: 9.27). 06/2005; 64(6):906-12. DOI: 10.1136/ard.2004.026526
Source: PubMed

ABSTRACT To determine whether a multimodal physiotherapy programme including taping, exercises, and massage is effective for knee osteoarthritis, and if benefits can be maintained with self management.
Randomised, double blind, placebo controlled trial; 140 community volunteers with knee osteoarthritis participated and 119 completed the trial. Physiotherapy and placebo interventions were applied by 10 physiotherapists in private practices for 12 weeks. Physiotherapy included exercise, massage, taping, and mobilisation, followed by 12 weeks of self management. Placebo was sham ultrasound and light application of a non-therapeutic gel, followed by no treatment. Primary outcomes were pain measured by visual analogue scale and patient global change. Secondary measures included WOMAC, knee pain scale, SF-36, assessment of quality of life index, quadriceps strength, and balance test.
Using an intention to treat analysis, physiotherapy and placebo groups showed similar pain reductions at 12 weeks: -2.2 cm (95% CI, -2.6 to -1.7) and -2.0 cm (-2.5 to -1.5), respectively. At 24 weeks, pain remained reduced from baseline in both groups: -2.1 (-2.6 to -1.6) and -1.6 (-2.2 to -1.0), respectively. Global improvement was reported by 70% of physiotherapy participants (51/73) at 12 weeks and by 59% (43/73) at 24 weeks. Similarly, global improvement was reported by 72% of placebo participants (48/67) at 12 weeks and by 49% (33/67) at 24 weeks (all p>0.05).
The physiotherapy programme tested in this trial was no more effective than regular contact with a therapist at reducing pain and disability.

Full-text

Available from: Rachelle Buchbinder, Jun 07, 2015
0 Followers
 · 
134 Views
  • Source
    Cochrane database of systematic reviews (Online) 01/2015; 1:CD004376. DOI:10.1002/14651858.CD004376.pub3 · 5.94 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Página 1: Osteoartrose de joelhos Parte I: Evidências sobre abordagens medicamentosas Resumo Osteoartrose de joelhos é doença prevalente, com tendência a aumentar em vista do prolongamento da vida e do incremento da obesidade nos países ocidentais, a qual traz sérias conseqüências físicas e emocionais (dor crônica, incapacidade funcional, redução da qualidade de vida, risco de fraturas), bem como sociais e econômicas (diminuição da força de trabalho e custo com consultas médicas repetidas e medidas corre-tivas). Para seu controle sintomático e de progressão de doença, medidas medicamentosas e não-medicamentosas são propostas, com boa evidência sobre sua eficácia e segurança. Aqui se faz uma revisão das evidências sobre os vários medicamentos testados para tra-tamento de OA de joelhos, tanto os analgésicos como outros com diferentes finalidades, pretendendo propiciar adequado balanço de benefício no momento de escolher um ou mais deles. Embora sem obtenção de cura com abordagens conservadoras, a OA de joelhos é mais bem controlada com um conjunto de estratégias medicamentosas e não-medicamentosas, realizadas por equipes profissionais multidisciplinares e requerendo forte adesão dos pacientes. *Lenita Wannmacher é professora de Farmacologia Clínica, aposentada da Universidade Federal do Rio Grande do Sul e atualmente da Universidade de Passo Fundo, RS. Atua como consultora do Núcleo de Assistência Farmacêutica da ENSP/FIOCRUZ para a questão de seleção e uso racional de medicamentos. É membro do Comitê de Especialistas em Seleção e Uso de Medicamentos Essenciais da OMS, Genebra, para o período 2005-2009. É autora de quatro livros de Farmacologia Clínica.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Although recent advances in knee osteoarthritis (OA) treatment and evaluation were achieved, to the best of our knowledge, few studies have evaluated the longitudinal effect of therapeutic modalities on the functional exercise capacity of patients with knee OA. The purpose was to investigate the effects of kinesiotherapy and electrotherapy on functional exercise capacity, evaluated using the six-minute walk test (6-MWT) in patients with bilateral knee OA. Secondary measurements included range of motion (ROM), severity of knee pain (VAS), and a measure of perceived health and physical function, evaluated using the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index. Methods A total of 40 women with bilateral knee OA were assigned to three groups: kinesiotherapy (KIN, n = 16), transcutaneous electrical nerve stimulation (TENS, n = 12), or ultrasound (US, n = 10). The groups underwent 12 weeks of intervention twice per week. The participants were subjected to the 6-MWT, ROM, VAS and WOMAC index. These tests were performed before and after the intervention. The study was focused on outpatients and was carried out at Universidade Estadual de Campinas, Brazil. Results At follow-up, the KIN and US groups had significantly higher 6-MWT distances (19.8 ± 21.7 and 14.1 ± 22.5%, respectively) compared with their respective pre-intervention values. All treatments were effective for reducing pain and improving the WOMAC index. Conclusions We demonstrated that the 6-MWT is a tool that can be used to evaluate improvements in the functional exercise capacity of patients submitted to a clinical intervention.
    BMC Musculoskeletal Disorders 09/2012; 13(1). DOI:10.1186/1471-2474-13-182 · 1.90 Impact Factor