Effectiveness of physical therapy & Knee osteoarthritis

    Knee osteoarthritis (OA) is a chronic progressive disease that imparts a substantial socioeconomic burden to society and healthcare systems. The prevalence of knee OA has dramatically risen in recent decades due to consistent increases in life expectancy and obesity worldwide. Patient education, physical exercise, and weight loss constitute the first-line knee OA treatment approach. However, less than 40% of patients with knee OA receive this kind of intervention. There is an unmet need for healthcare professionals treating individuals with knee OA to understand the current recommended treatment strategies to provide effective rehabilitation.

The pathology of knee OA affects the whole joint, causing synovial inflammation, cartilage damage, bone remodeling, and osteophyte formation. Typical symptoms include pain, muscle weakness, joint instability, brief morning stiffness, crepitus, and functional limitations. Frequently, symptoms are related to physical inactivity, which has been linked to morbidity and mortality in the contemporary era and is a significant contributor to the incidence of chronic diseases worldwide.

There is high-quality evidence demonstrating the effectiveness of education and exercise to improve function in individuals with knee OA. Some beneficial effects introduced by the interventions, including increased physical activity and quality of life, were maintained after one year. These results suggest that a combination of education and exercise could result in long-term reductions in the burden of knee OA and its costs to patients.

Non-pharmacological strategies

Current clinical practice guidelines recommend education and self-management, exercise, and weight loss (for overweight or obese patients) as the first-line treatments for knee OA. We consider these strategies to be the core of knee OA rehabilitation because they have been proven to effectively decrease pain and improve overall joint function and patient quality of life. I

Adjunct therapies

Several adjunct therapies are used as complements to core knee OA treatments to maximize outcomes for patients. Thermal modalities, laser therapy, therapeutic ultrasound, electrical stimulation, manual therapy techniques, taping, and acupuncture, among others, are some interventions that are commonly used.

Pharmacological strategies

For knee OA, local therapies are preferable as core pharmacological treatments. Appropriate monitoring of the patient during a pharmacological treatment, especially for the development of adverse effects, is also recommended.

Conclusion

Osteoarthritis is one of the most frequent diseases worldwide. The burden to society and health care systems is gradually increasing. It is our duty as healthcare professionals to leverage our access to high-quality evidence to increase the number of individuals receiving the appropriate core non-pharmacological treatments for knee OA. By doing so, we can increase the uptake of evidence-based guidelines in clinical practice of physical therapy.

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