Article

A broad spectrum of physical therapy exercise programs provides symptom relief
and functional benefit for patients with knee OA.
Manual physical therapy,
including tailored exercise programs provide relatively higher level benefit that
persists to one year. It is currently unknown if there are important differences
in the effects of different manual physical therapy techniques for patients with
knee OA and there are virtually no studies comparing manual physical therapy and
electrotherapy modalities.
The aim of the study was to compare long-term results
between three treatment groups (mobilization with movements [MWMs], passive joint
mobilization [PJM], and electrotherapy) to determine which treatment is most
effective in patients with knee OA. A single-blind randomized clinical trial with
parallel design was conducted in patients with knee OA. Seventy-two consecutive
patients (mean age 56.11 +/- 6.80 years) with bilateral knee OA were randomly
assigned to one of three treatment groups: MWMs, PJM, and electrotherapy. All
groups performed an exercise program and received 12 sessions. The primary
outcome measures of the functional assessment were the Western Ontario and
McMaster Universities Osteoarthritis index (WOMAC) and Aggregated Locomotor
Function (ALF) test scores. The secondary outcome measures were pain level,
measured using a pressure algometer and a visual analogue scale (VAS), range of
motion (ROM), measured using a digital goniometer, and muscle strength, evaluated
with a handheld dynamometer. Patients were assessed before treatment, after
treatment and after 1 year of follow-up. Patients receiving the manual physical
therapy interventions consisting of either MWM or PJM demonstrated a greater
decrease in VAS scores at rest, during functional activities, and during the
night compared to those in the electrotherapy group from baseline to after the
treatment (p < 0.05).
This improvement continued at the 1-year follow-up (p <
0.05). The MWMs and PJM groups also showed significantly improved WOMAC and ALF
scores, knee ROM and quadriceps muscle strength compared to those in the
electrotherapy group from baseline to 1-year follow-up (p < 0.05). In the
treatment of patients with knee OA, manual physical therapy consisting of either
MWM or PJM provided superior benefit over electrotherapy in terms of pain level,
knee ROM, quadriceps muscle strength, and functional level.

Langue : ANGLAIS