Therapy in Motion for OA

Osteoarthritis patients may benefit from manual and exercise physiotherapy plus usual care

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Osteoarthritis may sometimes be called the "wear and tear" form of arthritis, but that doesn't mean patients should stop moving to prevent further damage.

A recent study tested two types physical therapy for the treatment of osteoarthritis: manual physiotherapy and exercise physiotherapy.

Results showed that in combination with usual care, both manual and exercise physiotherapy led to improved pain, stiffness and physical function in patients with osteoarthritis, compared to usual care alone.

Combining the two physical therapies did not appear to lead to additional benefits.

"Stay active to protect your joints."

The study was led by Associate Professor Haxby Abbott, PhD, MScPT, of the University of Otago in New Zealand.

Usual care for osteoarthritis often involves over-the-counter medications like Tylenol (acetaminophen) or Advil (ibuprofen). In more severe cases, treatment may involve stronger prescription medications or surgery. However, physical therapy can play an important role in reducing the joint pain and stiffness that comes with osteoarthritis.

"The best type of physical exercise for osteoarthritic patients are exercises to improve mobility, range of motion, and strength around the joints to maintain endurance and daily function with everyday activities," said Diane Shiao, PT, MSPT, DPT, who was not involved in the study.

"[By] keeping the joints mobile and the muscles strong as well as protecting the osteoarthritic area, further joint deformities can be prevented," she said.

In their study, Dr. Abbott and colleagues aimed to assess the effectiveness of manual physiotherapy and exercise physiotherapy in addition to usual care in patients with hip or knee osteoarthritis.

The research involved 206 participants, 193 of whom followed through to the end of the study.

To measure symptoms of osteoarthritis, the researchers used the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). To get a score from the index, patients answer a questionnaire that assesses levels of pain, stiffness and physical function. For the purpose of this study, WOMAC scores ranged from 0 to 240, in which higher scores are a sign of worse pain, stiffness and function.

At the beginning of the study, patients' overall WOMAC score was about 100.8. After one year, patients treated with any physical therapy had improved WOMAC scores.

Compared to patients who received usual care alone, WOMAC scores for patients receiving physical therapy dropped by:

  • 28.5 percent in the manual therapy group
  • 16.4 percent in the exercise therapy group
  • 14.5 percent in the combined therapy group

In addition to WOMAC scores, the researchers assessed patients with physical performance tests. Study results showed that patients in the exercise therapy group performed better on these physical tests.

According to the authors, "Manual physiotherapy provided benefits over usual care that were sustained to one year. Exercise physiotherapy also provided physical performance benefits over usual care. There was no added benefit from a combination of the two therapies."

The study was published in the April issue of Osteoarthritis and Cartilage. Funding and disclosure information was not available.

Reviewed by: 
Review Date: 
March 18, 2013
Last Updated:
March 21, 2013