New Trial on Effective Therapy for Knee Osteoarthritis
What is Osteoarthritis?
According to the Mayo clinic, osteoarthritis is “the most common form of arthritis…. It occurs when the protective cartilage on the ends of your bones wears down over time. Although osteoarthritis can damage any joint in your body, the disorder most commonly affects joints in your hands, knees, hips and spine. Osteoarthritis symptoms can usually be effectively managed, although the underlying process cannot be reversed.”
Degeneration vs. Recovery
Whenever one experiences a degenerative symptom like osteoarthritis, the decision on treating it is particularly important. Since arthritis is a condition that never goes away, it has to be “managed,” instead. This poses an interesting problem for the Physical Therapist (PT). Unlike recovering from surgery, how can one effectively manage osteoarthritis, and is constant PT necessary?
The Clinical Trial
This was the crux of a recent clinical trial when treating osteoarthritis of the knee. The researchers set out with the following questions:
- Does the effect of treatment of osteoarthritis of the knee differ when patients receive manual therapy (MT) with exercise compared to subjects who don’t?
- Is treatment more effective when patients receive “booster” sessions (sessions conducted periodically as opposed to regularly) compared to those who don’t over a one year period?
The importance lies in the fact that osteoarthritis is degenerative. In other words: how regularly should one receive Manual Therapy (MT) as received in PT? Will it help or hinder the pain associated with the condition?
This is important information for PTs, who work with patients in a way that benefits them rather than aggravate an existing condition, especially since treatment is over a longer period of time. PT is usually administered over four to six weeks, so the researchers’ study of one year is also significant.
Likewise, how often should one exercise the knee with osteoarthritis? And is both MT and exercise useful in combination? The team were searching for a good amount of variables in order to make the treatment of this recurring condition more effective while minimizing aggravation.
The participants were put into four groups to test these hypotheses, with each group focusing on one aspect of this “puzzle.” The study was randomized and multi-centered, which means that the participants were picked at random and from different facilities. This allows the researchers to get a broader sample set of patients.
Clinical Trial’s Conclusions
The study, as noted, took one year to complete. After completed, the researchers analyzed their data and came to the conclusion that ” MT or use of boosters with exercise did not result in additive improvement in the primary outcome at 1 year. Secondary outcomes suggest MT may have some short term benefit, and booster sessions may improve responder status and knee pain at 1 year.”
In other words: it depends on the patient. In the short term, it seems that the use of MT is effective. For the longer term, it seems unnecessary for the patient to have regular PT sessions with exercise, but rather spacing it out helps alleviate the knee pain.
Additional Research Findings
Finally, the researchers conducted an “exploratory interaction analysis.” Interaction in statistics refers to possible situations when three or more variables are present. This research – secondary to the primary goal of the research – suggested that knee pain decreases for participants receiving boosters and increases for participants not receiving boosters from 9 weeks to 1 year.
Knowing Current Research is Important To Us
Onward Orthopedics does perform minimally invasive surgeries for knee osteoarthritis. Rest assured that the medical team of Onward Orthopedics read, and consider, these studies to then make careful post-operative prescriptions for the patient. The goal is to maximize effectiveness in the minimal amount of time necessary to be beneficial.
- ‘Exercise, Manual Therapy, and Use of Booster Sessions in Physical Therapy for Knee Osteoarthritis: A Multi-Center, Factorial Randomized Clinical Trial’. March 15, 2016. Accessed April 25, 2016. http://goo.gl/qz49s8
- Dictionary, Psychology. ‘What Is BOOSTER SESSIONS? Definition of BOOSTER SESSIONS (psychology Dictionary)’. Accessed May 30, 2016. http://psychologydictionary.org/booster-sessions/.
- Fitzgerald, GK, JM Fritz, JD Childs, GP Brennan, V Talisa, AB Gil, BD Neilson, and JH Abbott. ‘Exercise, Manual Therapy, and Use of Booster Sessions in Physical Therapy for Knee Osteoarthritis: A Multi-Center, Factorial Randomized Clinical Trial’. Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society. March 15, 2016,. Accessed April 25, 2016. http://www.ncbi.nlm.nih.gov/pubmed/26973326.
- Clinic, Mayo. Mayoclinic April 22, 2016,. Accessed May 30, 2016. http://www.mayoclinic.org/diseases-conditions/osteoarthritis/home/ovc-20198248.
- Wikipedia. Wikimedia Foundation, 2016. s.v ‘Interaction (statistics)’. Accessed May 30, 2016. https://en.wikipedia.org/wiki/Interaction_(statistics).