Pollard Henry, Ward Graham, Hoskins Wayne, Hardy Katie
Macquarie Injury Management Group, Department of Health and Chiropractic, Macquarie University, NSW 2109, Australia.
J Can Chiropr Assoc. 2008 Dec;52(4):229-42.
Knee osteoarthritis is a highly prevalent condition with a significant socioeconomic burden to society. It is known to effect sufferers through pain, loss of function and changes in health related quality of life. Management typically involves pharmacologic and/or exercise based therapy approaches to reduce pain. Previous studies have shown multimodal treatment approaches incorporating manual therapy to be efficacious. The aim of this study is to determine if a manual therapy technique knee protocol can alter the self reported pain experienced by a group of chronic knee osteoarthritis sufferers in a randomised controlled trial.
43 participants with a chronic, non-progressive history of osteoarthritic knee pain, aged between 47 and 70 years were randomly allocated following a screening procedure to an intervention group (n=26; 18 men and 8 women, mean age 56.5 years) or a control group (n=17; 11 men and 6 women, mean age 54.6 years). Participants were matched for present knee pain intensity measured on a visual analogue scale. The intervention consisted of the Macquarie Injury Management Group Knee Protocol whilst the control involved a non-forceful manual contact to the knee followed by interferential therapy set at zero. Participants received three treatments per week for two consecutive weeks with a follow up immediately after the final treatment. Post-treatment Participants completed 11 questions including present knee pain intensity and feedback regarding their response to treatment utilizing a visual analogue scale. Results were analysed using descriptive statistics.
Prior to the intervention, there was no significant differences in age or present knee pain intensity. Following treatment, the intervention group reported a significant decrease in the present pain severity (mean 1.9) when compared to the control group (mean 3.1). Response to treatment questions indicated that compared to the control group, the intervention group felt the intervention had helped them (intervention mean 7.0; control mean 3.4), felt it decreased their knee symptoms such as crepitus (intervention mean 6.0; control mean 3.4) and improved their knee mobility (intervention mean 6.4; control mean 3.4) and their ability to perform general activities (intervention mean 6.5; control mean 3.8). Importantly the MIMG Knee Protocol intervention group reported no adverse reactions during treatment.
A short-term manual therapy knee protocol significantly reduced pain suffered by participants with osteoarthritic knee pain and resulted in improvements in self-reported knee function immediately after the end of the 2 week treatment period.
膝关节骨关节炎是一种高度流行的疾病，给社会带来了巨大的社会经济负担。众所周知，它会通过疼痛、功能丧失以及与健康相关的生活质量变化影响患者。治疗通常包括药物和/或基于运动的治疗方法来减轻疼痛。先前的研究表明，结合手法治疗的多模式治疗方法是有效的。本研究的目的是在一项随机对照试验中确定一种手法治疗技术膝关节方案是否能改变一组慢性膝关节骨关节炎患者自我报告的疼痛。
43名患有慢性、非进行性骨关节炎膝关节疼痛病史的参与者，年龄在47至70岁之间，经过筛选程序后被随机分配到干预组（n = 26；18名男性和8名女性，平均年龄56.5岁）或对照组（n = 17；11名男性和6名女性，平均年龄54.6岁）。根据视觉模拟量表测量的当前膝关节疼痛强度对参与者进行匹配。干预包括麦格理损伤管理组膝关节方案，而对照组则是对膝关节进行非强力手法接触，随后将干扰疗法设置为零。参与者连续两周每周接受三次治疗，最后一次治疗后立即进行随访。治疗后，参与者完成11个问题，包括当前膝关节疼痛强度以及使用视觉模拟量表对他们对治疗的反应的反馈。结果采用描述性统计进行分析。
干预前，年龄或当前膝关节疼痛强度没有显著差异。治疗后，与对照组（平均3.1）相比，干预组报告当前疼痛严重程度显著降低（平均1.9）。对治疗问题的回答表明，与对照组相比，干预组感觉干预对他们有帮助（干预组平均7.0；对照组平均3.4），感觉它减轻了他们的膝关节症状，如摩擦音（干预组平均6.0；对照组平均3.4），改善了他们的膝关节活动度（干预组平均6.4；对照组平均3.4）以及他们进行一般活动的能力（干预组平均6.5；对照组平均3.8）。重要的是，麦格理损伤管理组膝关节方案干预组在治疗期间未报告不良反应。
一种短期的手法治疗膝关节方案显著减轻了患有骨关节炎膝关节疼痛的参与者的疼痛，并在为期2周的治疗期结束后立即改善了自我报告的膝关节功能。
