Adults with painful osteoarthritis of the knee should turn to exercise — aerobic, aquatic or strength training — as a good nonsurgical way to ease their pain and improve their functioning, a new review suggests.
To reach this conclusion, Dr. Tatyana Shamliyan, a senior research associate at the University of Minnesota, and her colleagues reviewed 193 studies that were published between 1970 and 2012.
“Several guidelines recommend nondrug treatment, including exercise, electrical stimulation, tai chi and esthetics,” Shamliyan said. Her team analyzed the evidence and came up with results that were sometimes at odds with those guidelines.
They looked at how the therapies affected pain, functioning and disability.
“Based on the analysis, we can’t conclude sustained benefit with tai chi, manual therapy or massage, or transcutaneous electrical [nerve] stimulation,” she said.
The electrical stimulation reduced pain, she found, for very short time periods, less than six weeks. Over time, the pain actually got worse, she noted.
The investigators found few physical therapy interventions worked to reduce pain or improve functioning or levels of disability.
Shamliyan said it’s important for those with knee pain from osteoarthritis — the “wear-and-tear” form — get a prescriptive exercise program of aerobics, aquatics or strength training from a physical therapist.
The research is published in the Nov. 6 issue of the Annals of Internal Medicine.
In the analysis, the researchers also found that perseverance counted. “We found some evidence that adherence, compliance with the exercise recommended was associated with better outcomes,” she said.
09/11/2012 : By Kathleen Doheny / Health Magazine.
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