TY - JOUR
T1 - Effects of orthopaedic manual therapy in knee osteoarthritis
T2 - a systematic review and meta-analysis
AU - Anwer, Shahnawaz
AU - Alghadir, Ahmad
AU - Zafar, Hamayun
AU - Brismée, Jean Michel
N1 - Funding Information:
The authors are grateful to the Deanship of Scientific Research, King Saud University for funding through Vice Deanship of Scientific Research Chairs. Conflict of interest: None declared.
Publisher Copyright:
© 2018 Chartered Society of Physiotherapy
PY - 2018/9
Y1 - 2018/9
N2 - Objective: This systematic review to aimed to evaluate the effects of orthopaedic manual therapy (OMT) on pain, improving function, and physical performance in patients with knee osteoarthritis (OA). Data sources: Four databases (PubMed, Web of Science, CENTRAL, and CINAHL) were searched. Study selection: Trials were required to compare OMT alone or OMT in combination with exercise therapy, with exercise therapy alone or control. Data extraction: Data extraction and risk assessment were done by two independent reviewers. Outcome measures were visual analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score, WOMAC function score, WOMAC global score, and stairs ascending-descending time. Results: Eleven randomized controlled trials were included (494 subjects), four of which had a PEDro score of 6 or higher, indicating adequate quality. The results of the meta-analysis indicated that reduction of VAS score in OMT compared with the control group was statistically insignificant (SDM: −0.59; 95% CI: −1.54 to −0.36; P = 0.224). The reduction of VAS score in OMT compared with exercise therapy group was statistically significant (SDM: −0.78; 95% CI: −1.42 to −0.17; P = 0.013). The reduction of WOMAC pain score in OMT compared with the exercise therapy group was statistically significant (SDM: −0.79; 95% CI: −1.14 to −0.43; P = 0.001). Similarly, the reduction of WOMAC function score in OMT compared with the exercise therapy group was statistically significant (SDM: −0.85; 95% CI: −1.20 to −0.50; P = 0.001). However, the reduction of WOMAC global score in OMT compared with the exercise therapy group was statistically insignificant (SDM: −0.23; 95% CI: −0.54 to −0.09; P = 0.164). The reduction of stairs ascending-descending time in OMT compared with the exercise therapy group was statistically significant (SDM: −0.88; 95% CI: −1.48 to −0.29; P = 0.004). Conclusions: This review indicated OMT compared with exercise therapy alone provides short-term benefits in reducing pain, improving function, and physical performance in patients with knee OA. Review registration: PROSPERO 2016:CRD42016032799.
AB - Objective: This systematic review to aimed to evaluate the effects of orthopaedic manual therapy (OMT) on pain, improving function, and physical performance in patients with knee osteoarthritis (OA). Data sources: Four databases (PubMed, Web of Science, CENTRAL, and CINAHL) were searched. Study selection: Trials were required to compare OMT alone or OMT in combination with exercise therapy, with exercise therapy alone or control. Data extraction: Data extraction and risk assessment were done by two independent reviewers. Outcome measures were visual analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score, WOMAC function score, WOMAC global score, and stairs ascending-descending time. Results: Eleven randomized controlled trials were included (494 subjects), four of which had a PEDro score of 6 or higher, indicating adequate quality. The results of the meta-analysis indicated that reduction of VAS score in OMT compared with the control group was statistically insignificant (SDM: −0.59; 95% CI: −1.54 to −0.36; P = 0.224). The reduction of VAS score in OMT compared with exercise therapy group was statistically significant (SDM: −0.78; 95% CI: −1.42 to −0.17; P = 0.013). The reduction of WOMAC pain score in OMT compared with the exercise therapy group was statistically significant (SDM: −0.79; 95% CI: −1.14 to −0.43; P = 0.001). Similarly, the reduction of WOMAC function score in OMT compared with the exercise therapy group was statistically significant (SDM: −0.85; 95% CI: −1.20 to −0.50; P = 0.001). However, the reduction of WOMAC global score in OMT compared with the exercise therapy group was statistically insignificant (SDM: −0.23; 95% CI: −0.54 to −0.09; P = 0.164). The reduction of stairs ascending-descending time in OMT compared with the exercise therapy group was statistically significant (SDM: −0.88; 95% CI: −1.48 to −0.29; P = 0.004). Conclusions: This review indicated OMT compared with exercise therapy alone provides short-term benefits in reducing pain, improving function, and physical performance in patients with knee OA. Review registration: PROSPERO 2016:CRD42016032799.
KW - Exercise
KW - Function
KW - Knee
KW - Orthopaedic manual therapy
KW - Osteoarthritis
KW - Pain
UR - http://www.scopus.com/inward/record.url?scp=85049881020&partnerID=8YFLogxK
U2 - 10.1016/j.physio.2018.05.003
DO - 10.1016/j.physio.2018.05.003
M3 - Review article
C2 - 30030035
AN - SCOPUS:85049881020
SN - 0031-9406
VL - 104
SP - 264
EP - 276
JO - Physiotherapy (United Kingdom)
JF - Physiotherapy (United Kingdom)
IS - 3
ER -