Article

Osteoarthritis (OA) is a leading cause of musculoskeletal pain and disability.
According to a study by Lawrence et al, an estimated 27 million Americans were
living with OA in 2008. This number will continue to increase as the population
of persons older than 65 years grows. Because of the increasing number of persons
who have this chronic condition that causes pain and decreases function, the
prevalence of this diagnosis in primary care and musculoskeletal clinics likely
will increase. The reduction of pain and improvement in function should be goals
of providers who treat these patients. Physical therapy (PT) is a commonly used
treatment modality for persons with OA. Many treatment modalities are available
within the scope of PT, including strength training, manual therapy, aquatic
therapy, electrical stimulation, and balance and perturbation training. A review
of the most recent and highest-quality literature regarding these modalities
found that strength training, aquatic therapy, and balance and perturbation
therapy were the most beneficial with respect to reducing pain and improving
function. Evidence clearly indicates that electrical stimulation likely has very
little impact on these variables, and evidence regarding manual therapy is
equivocal. Literature reviewing prognostic indicators for persons with OA who
will likely respond to PT reveal that persons with milder disease (ie, unilateral
OA, symptoms for less than 1 year, and a 40-m self-paced walking test of less
than 25.9 seconds) and those who have pain of 6 or greater on the numerical pain
rating scale are likely to have better outcomes with PT, which suggests that
earlier referral is preferable. Barriers to the acceptance of PT as a therapeutic
treatment for OA include fatalistic patient and provider perspectives, inadequate
analgesia, and a fear among some patients and providers that increased activity
will lead to progression of their OA.
CI - Copyright (c) 2012 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS