 |
 |
|
|
|  PubMed
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.
SUMMARIES FOR PATIENTS
Physical Therapy and Exercise for Knee Arthritis
1 February 2000 | Volume 132 Issue 3 | Page 173
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians-American Society of Internal Medicine.
The summary below is from the full report titled "Effectiveness of Manual Physical Therapy and Exercise in Osteoarthritis of the Knee. A Randomized, Controlled Trial." It is in the 1 February 1999 issue of Annals of Internal Medicine (volume 132, pages 173-181). The authors are G.D. Deyle, N.E. Henderson, R.L. Matekel, M.G. Ryder, M.B. Garber, and S.C. Allison.
What is the problem and what is known about it so far?
Osteoarthritis is the most common type of arthritis. One third of people between the ages of 63 and 94 have osteoarthritis in their knees that can be painful and may limit their ability to get up from a chair, stand, walk, or climb stairs. Treating ostearthritis with drugs does not always work well and often leads to drug-related side effects. There is some evidence that physical therapy and exercise helps people with osteoarthritis.
Why did the researchers do this particular study?
The researchers wanted to see whether specially designed physical therapy by experienced therapists, which included hands-on (manual) therapy and a supervised exercise program, would reduce pain and stiffness in persons with knee osteoarthritis and increase their ability to walk comfortably.
Who was studied?
Eighty-three patients with knee arthritis whose doctors had referred them to the physical therapy department of a large military hospital.
How was the study done?
At random, the researchers assigned patients to receive either the physical therapy program or placebo. (Placebo is an inactive therapy provided to a comparison group.) The placebo in this study was ultrasound treatment of the knee that was too weak to produce any medical effect. Physical therapy consisted of manipulation of the knee, hip, spine, and ankle by experienced therapists; patients were also taught knee exercises that they did both in the clinic and at home. The physical therapy and the placebo treatments were carried out two times a week for 4 weeks. At the beginning and end of the study, the researchers asked patients to rate their pain and stiffness by using a standard questionnaire. They also measured how far patients could walk in 6 minutes. Patients were then followed up for 1 year to see who needed surgery for their arthritis.
What did the researchers find?
Patients who received the physical therapy program increased the distance they were able to walk in 6 minutes. Patients who got placebo treatment showed no improvement in the distance walked. Physical therapy patients also reported less pain and stiffness than placebo patients. At 1 year, 5% of the group that had the physical therapy program and 20% of the placebo group had undergone knee surgery.
What were the limitations of the study?
It is not possible to determine whether it was the manual therapy, the exercise, or both aspects of the physical therapy program that helped patients. It is also not clear whether home exercise programs in the absence of physical therapy would achieve similar benefit, or whether the benefits of physical therapy and exercise extend longer than 1 year.
What are the implications of the study?
A physical therapy program consisting of manual therapy and exercise seems to benefit patients with knee arthritis. It may also delay or prevent the need for surgery.
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
Related articles in Annals:
This article has been cited by other articles:
|
|
 |
|
  M. FRANSEN and S. McCONNELL Land-based Exercise for Osteoarthritis of the Knee: A Metaanalysis of Randomized Controlled Trials J Rheumatol, June 1, 2009; 36(6): 1109 - 1117. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P Ravaud, R-M Flipo, I Boutron, C Roy, A Mahmoudi, B Giraudeau, and T Pham ARTIST (osteoarthritis intervention standardized) study of standardised consultation versus usual care for patients with osteoarthritis of the knee in primary care in France: pragmatic randomised controlled trial BMJ, February 23, 2009; 338(feb23_1): b421 - b421. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. J Leemrijse, I. C. Swinkels, and C. Veenhof Direct Access to Physical Therapy in the Netherlands: Results From the First Year in Community-Based Physical Therapy Physical Therapy, August 1, 2008; 88(8): 936 - 946. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.-H. Jan, J.-J. Lin, J.-J. Liau, Y.-F. Lin, and D.-H. Lin Investigation of Clinical Effects of High- and Low-Resistance Training for Patients With Knee Osteoarthritis: A Randomized Controlled Trial Physical Therapy, April 1, 2008; 88(4): 427 - 436. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. E Silva, V. Valim, A. P. C Pessanha, L. M Oliveira, S. Myamoto, A. Jones, and J. Natour Hydrotherapy Versus Conventional Land-Based Exercise for the Management of Patients With Osteoarthritis of the Knee: A Randomized Clinical Trial Physical Therapy, January 1, 2008; 88(1): 12 - 21. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Bedson, S. Mottram, E. Thomas, and G. Peat Knee pain and osteoarthritis in the general population: what influences patients to consult? Fam. Pract., October 1, 2007; 24(5): 443 - 453. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. L Currier, P. J Froehlich, S. D Carow, R. K McAndrew, A. V Cliborne, R. E Boyles, L. T Mansfield, and R. S Wainner Development of a Clinical Prediction Rule to Identify Patients With Knee Pain and Clinical Evidence of Knee Osteoarthritis Who Demonstrate a Favorable Short-Term Response to Hip Mobilization Physical Therapy, September 1, 2007; 87(9): 1106 - 1119. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. K Carter and J. A Rizzo Use of Outpatient Physical Therapy Services by People With Musculoskeletal Conditions Physical Therapy, May 1, 2007; 87(5): 497 - 512. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. S Hinman, S. E Heywood, and A. R Day Aquatic Physical Therapy for Hip and Knee Osteoarthritis: Results of a Single-Blind Randomized Controlled Trial Physical Therapy, January 1, 2007; 87(1): 32 - 43. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. D. Neumayr, C. Aguilar, A. N. Earles, H. E. Jergesen, C. M. Haberkern, B. F. Kammen, P. A. Nancarrow, E. Padua, M. Milet, B. N. Stulberg, et al. Physical Therapy Alone Compared with Core Decompression and Physical Therapy for Femoral Head Osteonecrosis in Sickle Cell Disease. Results of a Multicenter Study at a Mean of Three Years After Treatment J. Bone Joint Surg. Am., December 1, 2006; 88(12): 2573 - 2582. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Hambly, V. Bobic, B. Wondrasch, D. Van Assche, and S. Marlovits Autologous Chondrocyte Implantation Postoperative Care and Rehabilitation: Science and Practice Am. J. Sports Med., June 1, 2006; 34(6): 1020 - 1038. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. D Deyle, S. C Allison, R. L Matekel, M. G Ryder, J. M Stang, D. D Gohdes, J. P Hutton, N. E Henderson, and M. B Garber Physical Therapy Treatment Effectiveness for Osteoarthritis of the Knee: A Randomized Comparison of Supervised Clinical Exercise and Manual Therapy Procedures Versus a Home Exercise Program Physical Therapy, December 1, 2005; 85(12): 1301 - 1317. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. R Maly, P. A Costigan, and S. J Olney Contribution of Psychosocial and Mechanical Variables to Physical Performance Measures in Knee Osteoarthritis Physical Therapy, December 1, 2005; 85(12): 1318 - 1328. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Ottawa Panel Members, Ottawa Methods Group, L. Brosseau, G. A Wells, P. Tugwell, M. Egan, C.-J. Dubouloz, L. Casimiro, V. A Robinson, L. Pelland, et al. Ottawa Panel Evidence-Based Clinical Practice Guidelines for Therapeutic Exercises and Manual Therapy in the Management of Osteoarthritis Physical Therapy, September 1, 2005; 85(9): 907 - 971. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. V Wilder and J. P Barrett Jr The Association Between Medication Usage and Dropout Status Among Participants of an Exercise Study for People With Osteoarthritis Physical Therapy, February 1, 2005; 85(2): 142 - 149. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Ottawa Panel Members, Ottawa Methods Group, L. Brosseau, G. A Wells, P. Tugwell, M. Egan, C.-J. Dubouloz, L. Casimiro, V. A Robinson, L. Pelland, et al. Ottawa Panel Evidence-Based Clinical Practice Guidelines for Therapeutic Exercises in the Management of Rheumatoid Arthritis in Adults Physical Therapy, October 1, 2004; 84(10): 934 - 972. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. L Harrison The Influence of Pathology, Pain, Balance, and Self-efficacy on Function in Women With Osteoarthritis of the Knee Physical Therapy, September 1, 2004; 84(9): 822 - 831. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Bhattacharyya, D. Gale, P. Dewire, S. Totterman, M. E. Gale, S. McLaughlin, T. A. Einhorn, and D. T. Felson The Clinical Importance of Meniscal Tears Demonstrated by Magnetic Resonance Imaging in Osteoarthritis of the Knee J. Bone Joint Surg. Am., January 17, 2003; 85(1): 4 - 9. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K S Thomas, K R Muir, M Doherty, A C Jones, S C O'Reilly, and E J Bassey Home based exercise programme for knee pain and knee osteoarthritis: randomised controlled trial BMJ, October 5, 2002; 325(7367): 752 - 752. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G K. Fitzgerald, J. D Childs, T. M Ridge, and J. J Irrgang Agility and Perturbation Training for a Physically Active Individual With Knee Osteoarthritis Physical Therapy, April 1, 2002; 82(4): 372 - 382. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. W Flynn, J. Fritz, R. S Wainner, J. Whitman, G. D. Deyle, N. E Henderson, M. B Garber, R. L Matekel, M. G Ryder, S. C Allison, et al. On the Philadelphia Panel Articles Physical Therapy, March 1, 2002; 82(3): 286 - 292. [Full Text]
|
|
|
|
|
|
G. D. Deyle, N. E Henderson, M. B Garber, R. L Matekel, M. G Ryder, S. C Allison, and J. M Rothstein Is Manual Physical Therapy Distinct From Physical Therapy Clinical Practice? Physical Therapy, March 1, 2002; 82(3): 287 - 289. [Full Text]
|
|
|
|
|
|
C. M Davis, J. M Rothstein, A. Delitto, and The Philadelphia Panel More Questions Than Answers Physical Therapy, March 1, 2002; 82(3): 289 - 292. [Full Text]
|
|
|
|
 |
|
 M E van Baar, J Dekker, R A B Oostendorp, D Bijl, T. B Voorn, and J W J Bijlsma Effectiveness of exercise in patients with osteoarthritis of hip or knee: nine months' follow up Ann Rheum Dis, December 1, 2001; 60(12): 1123 - 1130. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Philadelphia Panel Members, Clinical Specialty Experts, J. Albright, R. Allman, R. P. Bonfiglio, A. Conill, B. Dobkin, A. A Guccione, S. Hasson, R. Russo, et al. Philadelphia Panel Evidence-Based Clinical Practice Guidelines on Selected Rehabilitation Interventions for Knee Pain Physical Therapy, October 1, 2001; 81(10): 1675 - 1700. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Lisse, L. Espinoza, S. Z. Zhao, S. D. Dedhiya, and J. T. Osterhaus Functional Status and Health-Related Quality of Life of Elderly Osteoarthritic Patients Treated With Celecoxib J. Gerontol. A Biol. Sci. Med. Sci., March 1, 2001; 56(3): 167M - 175. [Abstract] [Full Text]
|
|
|
|
 |
|
 R. J Petrella Is exercise effective treatment for osteoarthritis of the knee? Br. J. Sports Med., October 1, 2000; 34(5): 326 - 331. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Helewa Manual physical therapy and exercise improved function in osteoarthritis of the knee Evid. Based Med., September 1, 2000; 5(5): 145 - 145. [Full Text]
|
|
|
|
 |
|
 Physical Therapy for Knee Osteoarthritis Journal Watch Gastroenterology, April 1, 2000; 2000(401): 19 - 19. [Full Text]
|
|
|
|
 |
|
 Physical Therapy for Knee Osteoarthritis Journal Watch (General), February 4, 2000; 2000(204): 1 - 1. [Full Text]
|
|
