medwireNews: Results of a randomized trial suggest no improvements in pain or physical function for patients with knee osteoarthritis (OA) who undergo physical therapy.
The researchers randomly assigned participants to receive physical therapy – delivered as up to 8 physiotherapist-led sessions over a 4-month period or as an internet-based exercise program lasting up to 12 months – or to a wait-list control group.
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores improved by a mean of 6.73 points from baseline to month 4 among the 140 patients in the physiotherapist-led group and by 6.06 points for the 142 patients undertaking the internet-based program, compared with 3.37 points for the 68 participants in the wait-list control group, a nonsignificant difference.
Furthermore, improvements in WOMAC scores were not significantly different between patients in either physical therapy group and those in the control group at the 12-month follow-up.
In light of prior studies on the effectiveness of exercise for knee OA, it is “unclear” why physical therapy was not superior to the control, say Kelli Allen (University of North Carolina at Chapel Hill, USA) and co-investigators.
And they conclude in Osteoarthritis and Cartilage that “additional research is needed to develop strategies for maximizing the effectiveness of [physical therapy] interventions, including understanding which [physical therapy] treatments work best for which patients and optimizing intervention dose in the context of real-world clinical settings.”
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