K M Crossley1, B Vicenzino2, J Lentzos3, A G Schache3, M G Pandy3, H Ozturk3, R S Hinman4. 1. Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia; Department of Mechanical Engineering, The University of Melbourne, Parkville, Victoria, Australia; School of Allied Health, College of Science, Health and Engineering La Trobe University, Bundoora, Victoria 3086, Australia. Electronic address: k.crossley@uq.edu.au. 2. Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia. 3. Department of Mechanical Engineering, The University of Melbourne, Parkville, Victoria, Australia. 4. Centre for Health Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Parkville, Victoria, Australia.
Abstract
OBJECTIVE:Patellofemoral joint osteoarthritis (PFJ OA) contributes considerably to knee OA symptoms. This study aimed to determine the efficacy of a PFJ-targeted exercise, education manual-therapy and taping program compared to OA education alone, in participants with PFJ OA. METHODS: A randomised, participant-blinded and assessor-blinded clinical trial was conducted in primary-care physiotherapy. 92 people aged ≥40 years with symptomatic and radiographic PFJ OA participated. Physiotherapists delivered the PFJ-targeted exercise, education, manual-therapy and taping program, or the OA-education (control condition) in eight sessions over 12 weeks. Primary outcomes at 3-month (primary) and 9-month follow-up: (1) patient-perceived global rating of change (2) pain visual analogue scale (VAS) (100 mm); and (3) activities of daily living (ADL) subscale of the Knee injury and Osteoarthritis Outcome Score (KOOS). RESULTS:81 people (88%) completed the 3-month follow-up and data analysed on an intention-to-treat basis. Between-group baseline similarity for participant characteristics was observed. The exercise, education, manual-therapy and taping program resulted in more people reporting much improvement (20/44) than the OA-education group (5/48) (number needed to treat 3 (95% confidence interval (CI) 2 to 5)) and greater pain reduction (mean difference: -15.2 mm, 95% CI -27.0 to -3.4). No significant effects on ADL were observed (5.8; 95% CI -0.6 to 12.1). At 9 months there were no significant effects for self-report of improvement, pain (-10.5 mm, 95% CI -22.7 to 1.8) or ADL (3.0, 95% CI -3.7 to 9.7). CONCLUSION:Exercise, education, manual-therapy and taping can be recommended to improve short-term patient rating of change and pain severity. However over 9-months, both options were equivalent. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ACTRN12608000288325): https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=82878.
RCT Entities:
OBJECTIVE:Patellofemoral joint osteoarthritis (PFJ OA) contributes considerably to knee OA symptoms. This study aimed to determine the efficacy of a PFJ-targeted exercise, education manual-therapy and taping program compared to OA education alone, in participants with PFJ OA. METHODS: A randomised, participant-blinded and assessor-blinded clinical trial was conducted in primary-care physiotherapy. 92 people aged ≥40 years with symptomatic and radiographic PFJ OA participated. Physiotherapists delivered the PFJ-targeted exercise, education, manual-therapy and taping program, or the OA-education (control condition) in eight sessions over 12 weeks. Primary outcomes at 3-month (primary) and 9-month follow-up: (1) patient-perceived global rating of change (2) pain visual analogue scale (VAS) (100 mm); and (3) activities of daily living (ADL) subscale of the Knee injury and Osteoarthritis Outcome Score (KOOS). RESULTS: 81 people (88%) completed the 3-month follow-up and data analysed on an intention-to-treat basis. Between-group baseline similarity for participant characteristics was observed. The exercise, education, manual-therapy and taping program resulted in more people reporting much improvement (20/44) than the OA-education group (5/48) (number needed to treat 3 (95% confidence interval (CI) 2 to 5)) and greater pain reduction (mean difference: -15.2 mm, 95% CI -27.0 to -3.4). No significant effects on ADL were observed (5.8; 95% CI -0.6 to 12.1). At 9 months there were no significant effects for self-report of improvement, pain (-10.5 mm, 95% CI -22.7 to 1.8) or ADL (3.0, 95% CI -3.7 to 9.7). CONCLUSION: Exercise, education, manual-therapy and taping can be recommended to improve short-term patient rating of change and pain severity. However over 9-months, both options were equivalent. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ACTRN12608000288325): https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=82878.
Authors: H F Hart; K M Crossley; D Felson; M Jarraya; A Guermazi; F Roemer; C E Lewis; J Torner; M Nevitt; J J Stefanik Journal: Osteoarthritis Cartilage Date: 2018-02-07 Impact factor: 6.576
Authors: Erin M Macri; Tuhina Neogi; Irina Tolstykh; Rafael Widjajahakim; Cora E Lewis; James C Torner; Michael C Nevitt; Michael Roux; Joshua J Stefanik Journal: Arthritis Care Res (Hoboken) Date: 2020-07-03 Impact factor: 4.794
Authors: Regina Wing Shan Sit; Keith Kwok Wai Chan; Dan Zou; Dicken Cheong Chun Chan; Benjamin Hon Kei Yip; Daisy Dexing Zhang; Ying Ho Chan; Vincent Chi Ho Chung; Kenneth Dean Reeves; Samuel Yeung Shan Wong Journal: Ann Fam Med Date: 2018-11 Impact factor: 5.166
Authors: Erin M Macri; Adam G Culvenor; Hayden G Morris; Timothy S Whitehead; Trevor G Russell; Karim M Khan; Kay M Crossley Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-05-09 Impact factor: 4.342
Authors: Natalie J Collins; Tuhina Neogi; Bill Vicenzino; Ali Guermazi; Frank W Roemer; Cora E Lewis; James C Torner; Michael C Nevitt; Joshua J Stefanik Journal: J Rheumatol Date: 2020-03-01 Impact factor: 4.666