Few PT interventions effective for knee osteoarthritis

(HealthDay)—Only a few physical therapy (PT) interventions are effective for knee pain secondary to osteoarthritis, specifically exercise and ultrasonography, according to a review published in the Nov. 6 issue of the Annals of Internal Medicine.

Shi-Yi Wang, M.D., Ph.D., from the University of Minnesota in Minneapolis, and colleagues conducted a literature review to identify studies evaluating interventions for community-dwelling adults with knee osteoarthritis. Data from 84 randomized controlled trials (RCTs) regarding 13 PT interventions on pain (58 RCTs), physical function (36 RCTs), and disability (29 RCTs) were used in meta-analyses.

The researchers identified low-strength evidence that aerobic (11 RCTs) and aquatic (three RCTs) exercise correlated with improvement in disability, and that aerobic exercise (19 RCTs), strengthening exercise (17 RCTs), and ultrasonography (six RCTs) correlated with reduced pain and improved function. Clinically important improvements in pain and disability were demonstrated in several individual RCTs with aerobic exercise. No sustained benefit was derived from other PT interventions. Similar benefits were seen in individual RCTs using aerobic, aquatic, and strengthening exercise. There were few adverse events and they did not prevent participants from continuing treatment.

"Our analysis suggests that only a few PT interventions were effective, specifically exercise (aerobic, aquatic, strengthening, and proprioception) and ultrasonography," the authors write. "No single PT intervention improved all outcomes, and some interventions, specifically diathermy, orthotics, and magnetic stimulation, demonstrated no benefit."