Efficacy of physiotherapy management of knee joint osteoarthritis: a randomised, double blind, placebo controlled trial
Kim L Bennell,Rana S Hinman,Ben R Metcalf,Rachelle Buchbinder,Jenny McConnell,Gawain I McColl,Sally Green,Kay M. Crossley +7 more
TLDR
The physiotherapy programme tested in this trial was no more effective than regular contact with a therapist at reducing pain and disability.Abstract:
Objective: 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.
Methods: 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.
Results: 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).
Conclusions: The physiotherapy programme tested in this trial was no more effective than regular contact with a therapist at reducing pain and disability.read more
Citations
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OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines
Weiya Zhang,R W Moskowitz,George Nuki,S Abramson,R D Altman,Nigel K Arden,Sita M A Bierma-Zeinstra,K D Brandt,P Croft,Michael Doherty,Maxime Dougados,Marc C. Hochberg,David J. Hunter,K Kwoh,L S Lohmander,Peter Tugwell +15 more
TL;DR: Twenty-five carefully worded recommendations have been generated based on a critical appraisal of existing guidelines, a systematic review of research evidence and the consensus opinions of an international, multidisciplinary group of experts for the management of hip and knee osteoarthritis.
Journal ArticleDOI
OARSI recommendations for the management of hip and knee osteoarthritis: part III: Changes in evidence following systematic cumulative update of research published through January 2009
Weiya Zhang,George Nuki,Roland W. Moskowitz,S.B. Abramson,Roy D. Altman,Nigel K Arden,S.M.A. Bierma-Zeinstra,Kenneth D. Brandt,Peter Croft,Michael Doherty,Maxime Dougados,Marc C. Hochberg,David J. Hunter,Kent Kwoh,L.S. Lohmander,Peter Tugwell +15 more
TL;DR: In this paper, a systematic literature search was undertaken using MEDLINE, EMBASE, CINAHL, AMED, Science Citation Index and the Cochrane Library to examine whether research evidence has changed from 31 January 2006 to 31 January 2009.
Journal ArticleDOI
Evidence for prescribing exercise as therapy in chronic disease.
TL;DR: The evidence for prescribing exercise therapy in the treatment of metabolic syndrome‐related disorders (insulin resistance, type 2 diabetes, dyslipidemia, hypertension, obesity), heart and pulmonary diseases, muscle, bone and joint diseases, and cancer, depression, asthma and type 1 diabetes is presented.
Journal ArticleDOI
EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis
Linda Fernandes,Kåre Birger Hagen,Johannes W. J. Bijlsma,Øyvor Andreassen,Pia Christensen,Philip G. Conaghan,Michael Doherty,Rinie Geenen,Alison Hammond,Ingvild Kjeken,L. Stefan Lohmander,Hans Lund,Christian D Mallen,Tiziana Nava,Susan Oliver,Karel Pavelka,Irene A Pitsillidou,José António Raimundo Mendes da Silva,Jenny de la Torre,Gustavo Zanoli,Theodora P. M. Vliet Vlieland +20 more
TL;DR: Eleven evidence-based recommendations for the non-pharmacological core management of hip and knee OA were developed, concerning the following nine topics: assessment, general approach, patient information and education, lifestyle changes, exercise, weight loss, assistive technology and adaptations, footwear and work.
Journal ArticleDOI
OARSI recommendations for the management of hip and knee osteoarthritis, part I: critical appraisal of existing treatment guidelines and systematic review of current research evidence.
Weiya Zhang,R W Moskowitz,George Nuki,S Abramson,R D Altman,Nigel K Arden,Sita M A Bierma-Zeinstra,K D Brandt,P Croft,Michael Doherty,Maxime Dougados,Marc C. Hochberg,David J. Hunter,K Kwoh,L S Lohmander,Peter Tugwell +15 more
TL;DR: A critical appraisal of published guidelines and a systematic review of more recent evidence for relevant therapies for hip and knee osteoarthritis was undertaken, finding that only 20 treatment modalities addressed by these guidelines were universally recommended.
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