Exercises versus Manual Therapy in Elderly Patients with Knee Osteoarthritis

Abstract

Background: Knee osteoarthritis (OA) is a degenerative articular disease which is slowly evolving that appears to originate in the cartilage by breaking down and affects the underlying bone, soft tissues, and synovial fluid. Age is the strongest determinant of knee osteoarthritis. As the population ages, the number of persons suffering from OA is expected to increase. The prevalence of OA increases after the age of 40 years in women and 50 years in men. The individuals with knee OA have functional limitations due to pain , such as inability to perform Activities of Daily Living (ADL) or Instrumental Activities of Daily Living (IADL). Purpose: was to evaluate the effectiveness of exercises alone versus manual therapy plus exercises in knee osteoarthritis elderly patients. Design: Randomized clinical trail. Subjects and Methods: 40 male patients with osteoarthritis of the knee who were randomly assigned to one of two groups that received exercises alone (n = 20; mean age, 60 years) or manual therapy and exercises (n = 20; mean age, 61 years). Both groups were received their programs for 4 weeks; two sessions per week. Measurements: Sum of the function, pain, and stiffness subscore of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), VAS and ROM of knee. An assessment was made for each group at the initial visit (before initiation of treatment) and at end of program. Results: Both groups showed significant improvement in WOMAC score, VAS and ROM of knee. There were no statistical significant difference between the two groups except the ROM of knee which is significantly different. Conclusion: Manual therapy improves the effectiveness of the treatment program of exercises in treating symptoms of knee OA and improves function in elderly people with knee OA. KEY WORDS: Knee osteoarthritis, Exercises, Manual therapy.