Physical therapies in the management of osteoarthritis: current state of the evidence

Current Opinion in Rheumatology
K L BennellR S Hinman

Abstract

This review considers the role of physical therapies in osteoarthritis management, highlighting key findings from systematic reviews and randomized controlled trials published in the last 2 years. Three new trials question the role of manual therapy for hip and knee osteoarthritis. No between-group differences in outcome were detected between a multimodal programme including manual therapy and home exercise, and placebo in one trial; a second trial found no benefit of adding manual therapy to an exercise programme, while a third trial reported marginal benefits over usual care that were of doubtful importance. Recent trials have also found no or uncertain clinical benefits of transcutaneous electrical nerve stimulation (TENS) or acupuncture, or of valgus braces or lateral wedge insoles for pain and function in knee osteoarthritis. Available evidence suggests a small to moderate effect of exercise in comparison with not exercising for hip or knee osteoarthritis, although optimum exercise prescription and dosage are unclear. One trial also observed a delay in joint replacement in people with hip osteoarthritis. Two trials have reported conflicting findings about the effects of exercise for hand osteoarthritis. Other than exercise...Continue Reading

References

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Citations

Oct 26, 2016·International Journal of Orthopaedic and Trauma Nursing·Thomas W WainwrightRobert G Middleton
Apr 5, 2016·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Giuseppe FilardoGiuseppe M Peretti
Oct 28, 2016·Advances in Therapy·Nicholas J MurphyDavid J Hunter
May 9, 2016·Annals of Physical and Rehabilitation Medicine·Christelle NguyenFrançois Rannou
Oct 5, 2016·Clinical Rehabilitation·Shantil M DickersonMegan B Donaldson
Jun 2, 2016·Therapeutic Advances in Musculoskeletal Disease·Peter WehlingWilliam Maixner
Jan 24, 2018·Journal of Orthopaedic Surgery and Research·Ning MaJianhua Xiao
Nov 4, 2016·Annals of Biomedical Engineering·Ryan T Lewinson, Darren J Stefanyshyn
Oct 28, 2019·Journal of Clinical Medicine·David RicePatrick Finan
Dec 17, 2016·Chiropractic & Manual Therapies·E J Thoomes
Aug 10, 2021·Journal of Back and Musculoskeletal Rehabilitation·Serpil TunaNilüfer Balcı

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