As you age, aches and pains become a bigger part of your life, but the good news is that some of these pains are preventable with therapeutic interventions. Approximately 40% of the population experiences knee osteoarthritis (OA), with symptoms including an increase in achiness after maintaining one position for too long, swelling, pain with stairs or hills, and weakness.

Physical therapists and other healthcare professionals are tasked with the responsibility of determining appropriate regimens for the growing population of persons who suffer from joint OA. Because it affects so many people, there is much discussion on what is the appropriate number of visits, frequency, and length of care provided in order to maximize the outcome and patient satisfaction. The first concern, of course, is decrease in pain in conjunction with increase in function. Because OA is a structural dysfunction, conservative treatment aims to treat the symptoms without requiring invasive procedures such as surgery.

A recent study by Abbott and colleagues compared persons with advanced knee osteoarthritis between four groups: exercise only for 8 weeks, exercise only for 8 week + “booster sessions”, exercise and manual therapy for 8 weeks only, exercise and manual therapy for 8 weeks + “booster session”. Each of these groups had a total of 12 physical therapy sessions. The groups with no booster sessions received all 12 within a nine week period. The groups with booster sessions received 8 sessions in the first nine week period, followed by two booster sessions at a 5 month follow up, a third booster at 9 months, and the final booster session at 11 months. At a one-year follow up with all participants, the researchers found that the subjects that had booster sessions and manual therapy had a significant increase over those with one exercise interventions and those with no booster sessions.

What this means for our patients:

  • Having one-on-one time to individualize an exercise program and teach proper form will improve outcomes for that patient
  • Providing manual therapy and including stretches, proprioceptive neuromuscular facilitation, and soft tissue mobilization will improve patient outcome
  • Tailoring an at-home exercise program for each patient will complement the interventions performed in clinic
  • Scheduling regular follow-ups to modify and progress interventions will significantly improve the patient outcomes compared to those discharged after a short time, even if the total number of visits are the same.

 

Link to article abstract: http://www.ncbi.nlm.nih.gov/pubmed/26416334