Effect of a physiotherapy rehabilitation program on knee osteoarthritis in patients with different pain intensities.
Amr Almaz Abdel-Aziem, Elsadat Saad Soliman, Dalia Mohammed Mosaad and 1 others
PMID 29545702WHAT IT FOUND
In 60 people with moderate knee OA, a 4-week program combining pulsed electromagnetic field, ultrasound, stretching and strengthening lowered pain and improved knee motion, quadriceps strength and WOMAC disability.
The moderate-pain group had largest changes in pain, motion and WOMAC. All groups received treatment.
Key findings
01The combined program of pulsed electromagnetic field, ultrasound, stretching and strengthening was given to all pain groups, and pain, knee motion, quadriceps strength and WOMAC scores improved significantly.
02The moderate pain group had significantly greater changes in pain, knee motion and WOMAC than the mild and severe groups. For quadriceps strength, the paper reported no significant difference among groups, but also reported a significantly greater change in the moderate group than the severe group.
03Because all groups received the same combined treatment, the contribution of any single component cannot be separated.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study recruited by convenience sampling, so the participants may not represent all people with knee OA. 66 patients were recruited, but 60 were analysed because some withdrew or were lost to follow-up. All participants received the same combined treatment, and the paper does not show how much improvement would occur without treatment. The same therapist evaluated and treated patients, which can influence expectations and measurement. The follow-up was only 4 weeks, so long-term effects are unknown. The study did not control daily activities and did not use functional tests such as the 6-minute walk test. The paper did not state a primary outcome.
Declared interests
No conflict of interest is declared by authors.
The easy way to misread this
Do not read the gains as proof that the physiotherapy program caused them. The study compared treated pain groups, not treated and untreated groups, so time, attention and expectations could explain the changes.