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: 10.38). 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.

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Available from: Rachelle Buchbinder, Jul 30, 2015
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    • "Numerous treatment modes are used, including manual therapy, knee taping, exercise, massage , education and guidance regarding handling of assistive devices (e.g. walking aids) [9] [10]. Central aims of the therapeutic process are facilitation of the patients' functioning, activities and level of participation, and encouragement to deal with limitations of physical activities and restrictions in daily activities and participation in an adequate way. "
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    ABSTRACT: Osteoarthritis is a common chronic disease associated with functional impairments and activity limitations, as well as participation restrictions. The Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for Osteoarthritis is an application of the ICF and represents the typical spectrum of problems in functioning of patients with osteoarthritis. To validate the Comprehensive ICF Core Set for Osteoarthritis from the perspective of physical therapists. Physical therapists experienced in the treatment of patients with osteoarthritis were asked about patients' problems, resources and aspects of the environmental factors treated by physical therapists in patients with osteoarthritis in a three-round, electronic-mail survey using the Delphi technique. Responses were linked to the ICF. Seventy-two experts from 22 countries named 744 meaningful concepts that covered all ICF components. One hundred and fifty-two ICF categories were linked to these answers, 32 concepts were linked to the not-yet-developed personal factors component, and 14 issues were not covered by a single ICF category. Twelve ICF categories were not represented in the Comprehensive ICF Core Set for Osteoarthritis, although at least 75% of the participants rated them as important. The content validity of the ICF was widely supported by the physical therapists. However, several issues were raised that were not covered and need to be investigated further.
    Physiotherapy 03/2011; 97(1):3-16. DOI:10.1016/ · 2.11 Impact Factor
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    • "En cuanto a las características de las intervenciones osciló entre las cuatro (Evgeniadis et al., 2008) y 72 semanas (Rejeski et al., 2002). La frecuencia semanal de las sesiones fue de una (Bennell et al., 2005) a cinco sesiones (An et al., 2008), siendo lo más habitual tres sesiones semanales (Baker et al., 2001; Rejeski et al., 2002; Rooks et al., 2006; Evgeniadis et al., 2008; Aglamis et al., 2009) y la duración de estas sesiones osciló entre los 30 (Bennell et al., 2005; Rooks et al., 2006; An et al., 2008) y 60 minutos (Rejeski et al., 2002; Cochrane et al., 2005; Lee et al., 2009) ( "
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    ABSTRACT: La osteoartrosis (OA) es una enfermedad degenerativa de las articulaciones. El ejercicio físico se ha convertido en una alternativa de tratamiento no farmacológico muy utilizado en la actualidad. El objetivo de esta revisión fue describir el “state of the art” de los efectos de los programas de ejercicio físico sobre la calidad de vida en pacientes con OA de miembros inferiores. Se realizó una búsqueda en varias bases de datos de los términos “osteoarthritis”, “knee”, “hip”, “exercise”, “health-related quality of life” y “SF-36”. Los criterios de inclusión fueron: a) sujetos: adultos diagnosticados de OA; b) tipo de estudio: experimental; c) tipo de intervención: programa de ejercicio físico; d) duración del programa: más de 4 semanas y e) valoración de la calidad de vida relacionada con la salud: cuestionario SF-36. Se encontraron diez estudios que evaluaron la influencia de diferentes programas de ejercicio físico sobre la calidad de vida relacionada con la salud. En general las conclusiones que se pueden extraer de este trabajo son (i) los programas que combinan trabajo de fuerza y aeróbico (20%) consiguen mejoras en alguna de las dimensiones de la calidad de vida relacionada con la salud en sujetos con OA de miembros inferiores; (ii) el trabajo en el medio acuático y terrestre (Tai Chi Chuan y fuerza) obtienen mejoras en la calidad de vida, siendo mayores en los programas que desarrollan la fuerza de forma isotónica (10%); (iii) los programas de fuerza y aeróbico consiguen mejoras en las cuatro dimensiones del componente físico (20%) y mental (10 %), siendo estas más discretas con el Tai Chi; (iv) las mejoras de la calidad de vida se producen en programas a corto plazo (8-12 semanas), obteniéndose cambios más discretos en programas a largo plazo (48-72 semanas).
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    • "Référence Type d'étude Durée Nombre de patients Intervention Bennell et al. 2005 [4] "
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    ABSTRACT: To develop clinical practice guidelines about the use of taping in the management of lower limb osteoarthritis. We used the methodology advocated by the SOFMER (French Society for Physical and Rehabilitation Medicine), which combines a literature review, collection of data on current practice patterns, and validation of the recommendations by a multidisciplinary panel of experts. Our evaluation focused on the effectiveness of taping in relieving symptoms of lower limb osteoarthritis. Ankle taping for osteoarthritis is not recommended, given the absence of published data and very low level of use in France. Few studies are available on knee taping for osteoarthritis. Published studies exhibit a number of methodological weaknesses. There is no strong evidence that taping is effective in knee osteoarthritis, and this treatment modality is rarely used in France. Therefore, there is no strong basis at present for recommending taping as part of the management of knee osteoarthritis. Well-designed studies of patellar taping to modify the relationships between the patellar and the trochlea are desirable to determine whether this treatment modality benefits patients with knee osteoarthritis, most notably those with involvement of the femoropatellar compartment.
    Joint, bone, spine: revue du rhumatisme 08/2008; 75(4):475-8. DOI:10.1016/j.jbspin.2007.12.006 · 3.22 Impact Factor
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