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

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.

journal_name

Ann Rheum Dis

authors

Bennell KL,Hinman RS,Metcalf BR,Buchbinder R,McConnell J,McColl G,Green S,Crossley KM

doi

10.1136/ard.2004.026526

subject

Has Abstract

pub_date

2005-06-01 00:00:00

pages

906-12

issue

6

eissn

0003-4967

issn

1468-2060

pii

64/6/906

journal_volume

64

pub_type

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