Physical Therapy Is Beneficial in Knee Osteoarthritis.

[Argirios Argiriou]

Jonathan S. Coblyn, MD reviewing Juhl C et al. Arthritis Rheumatol 2014 Mar.

Thrice-weekly exercise focused on quadriceps strengthening is a useful adjunct for OA patients.

Patients with knee osteoarthritis (OA) can be offered arthroscopy, medications, physical therapy (PT), or other treatment modalities. However, several randomized trials have suggested that arthroscopic interventions do not benefit most patients with knee OA (NEJM JW Gen Med Sep 16 2008 and NEJM JW Gen Med Jul 16 2002). In another study, PT was as effective as arthroscopy for meniscal tears in patients with OA (NEJM JW Gen Med Mar 28 2013). PT alone alleviates pain for many patients, but the optimal regimen is unknown.

To evaluate various PT regimens for patients with knee OA, researchers evaluated 48 trials in which PT was compared with non-exercise control interventions. The most efficacious PT programs provided aerobic, resistance, or performance exercises but did not mix exercise types. More pain reduction occurred with quadriceps-specific exercises than with other types of exercise. Best results were obtained with supervised, thrice-weekly PT programs with durations of at least 4 weeks.

Comment

Treating patients with knee osteoarthritis is not standardized. Patients can be offered analgesia, nonsteroidal anti-inflammatory drugs, steroid injections, hyaluronate compounds, arthroscopic interventions, or physical therapy. This study helps clinicians choose among these options. PT clearly helps relieve pain in patients with OA, and perhaps thrice-weekly PT for 4 weeks should be an adjunct treatment for all patients who are not responding to their current therapy.

Citation(s):

Juhl C et al. Impact of exercise type and dose on pain and disability in knee osteoarthritis: A systematic review and meta-regression analysis of randomized controlled trials. Arthritis Rheumatol 2014 Mar; 66:622. (Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος)

- See more at: Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος