Joint mobilization plus exercise beneficial for knee osteoarthritis

Patellar mobilization therapy (PMT) plus exercise has the potential to reduce pain and improve function and quality of life for patients with knee osteoarthritis, according to a phase 2 study published Nov. 12 in the Annals of Family Medicine.

Clinical applications of biomechanics in knee osteoarthritis. Mobilize Clinical Biomechanics Lab, University of Waterloo

HealthDay, Medical Xpress December 3, 2018

Regina Wing Shan Sit MBBS, from the Chinese University of Hong Kong, and colleagues randomly assigned 208 primary care patients with knee osteoarthritis to either an intervention group (three PMT treatment sessions from primary care physicians at two-month intervals with concomitant prescription of a home-based vastus medialis oblique muscle exercise) or a control group, who were put a wait list.

The researchers found a greater improvement in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score in the intervention group than in the control group at 24 weeks. They also observed significant differences in all secondary outcomes between the groups, including the WOMAC composite, function, and stiffness scores; the visual analog scale score for pain; and objective physical function tests (30-second chair stand, 40-minute walk test, timed up and go test, and EuroQol-5D).

“Future clinical trials with comparison to other active comparator controls will help determine the overall efficacy and facilitate the deployment of PMT in real-world practice,” the authors write.

Source Medical Xpress

Clinic-Based Patellar Mobilization Therapy for Knee Osteoarthritis: A Randomized Clinical Trial, Sit RWS, Chan KKW, Zou D, Chan DCC, Yip BHK, Zhang DD, Chan YH, Chung VCH, Reeves KD, Wong SYS. Ann Fam Med. 2018 Nov;16(6):521-529. doi: 10.1370/afm.2320. Full text

  Further reading
Exercise as medicine to be prescribed in osteoarthritis, Ravalli S, Castrogiovanni P, Musumeci G. World J Orthop. 2019 Jul 18;10(7):262-267. doi: 10.5312/wjo.v10.i7.262. eCollection 2019 Jul 18. Review. Full text

Osteoarthritis: Trauma vs Disease, Jiménez G, Cobo-Molinos J, Antich C, López-Ruiz E. Adv Exp Med Biol. 2018;1059:63-83. doi: 10.1007/978-3-319-76735-2_3. Review.

A Combined Patient and Provider Intervention for Management of Osteoarthritis in Veterans: A Randomized Clinical Trial, Allen KD, Yancy WS Jr, Bosworth HB, Coffman CJ, Jeffreys AS, Datta SK, McDuffie J, Strauss JL, Oddone EZ. Ann Intern Med. 2016 Jan 19;164(2):73-83. doi: 10.7326/M15-0378. Epub 2015 Dec 22. Full text

Muscle Power Is an Independent Determinant of Pain and Quality of Life in Knee Osteoarthritis, Reid KF, Price LL, Harvey WF, Driban JB, Hau C, Fielding RA, Wang C. Arthritis Rheumatol. 2015 Dec;67(12):3166-73. doi: 10.1002/art.39336.

Physical activity ameliorates cartilage degeneration in a rat model of aging: a study on lubricin expression, Musumeci G, Castrogiovanni P, Trovato FM, Imbesi R, Giunta S, Szychlinska MA, Loreto C, Castorina S, Mobasheri A. Scand J Med Sci Sports. 2015 Apr;25(2):e222-30. doi: 10.1111/sms.12290. Epub 2014 Jul 9.

Also see
With osteoarthritis and exercise, some pain leads to gains in The Globe and Mail
Combined patient, physician intervention ups function in OA in Medical Xpress

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