A recent study in the 2021 edition of Journal of Clinic Research compared the use of manual therapy and exercises to exercise alone for the management of knee osteoarthritis.
The study found that the group that received manual therapy and exercise had a better improvement in pain and functional improvement over participants who only received exercises. Details are below, the full study can be found here.
Reza MK, Shaphe MA, Qasheesh M, et al. Efficacy of Specified Manual Therapies in Combination with a Supervised Exercise Protocol for Managing Pain Intensity and Functional Disability in Patients with Knee Osteoarthritis. J Pain Res. 2021 Jan 26;14:127-138. doi: 10.2147/JPR.S285297. eCollection 2021. (Original study)
Purpose: The current study aimed to determine the efficacy of specified manual therapies in combination with a supervised exercise protocol for managing pain intensity and functional disability in patients with knee osteoarthritis.
Methods: The study was based on a two-arm parallel-group randomized controlled trial design, including a total of 32 participants with knee osteoarthritis randomly divided into groups A and B. Group A received a supervised exercise protocol; however, group B received specified manual therapies in combination with a supervised exercise protocol. Pain and functional disability were measured with the numeric pain rating scale (NPRS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), respectively. Data were collected at baseline (pre-intervention), 2 weeks, and 4 weeks post-intervention. To evaluate the efficacy of specific manual therapies with supervised exercise compared to supervised exercise alone, an unpaired t-test and repeated measures ANOVA were used to analyze the data, keeping the level of significance at p<0.05.
Results: A significant (p<0.05) mean difference (?MD) was found within group A and group B for both outcomes when we compared their baseline scores with 2-week (group A, NPRS: ?MD=-1.56 and WOMAC: ?MD=14.94; group B, NPRS: ?MD=2.06 and WOMAC: ?MD=22.19) and 4-week post-intervention scores (group A, NPRS: ?MD=0.62 and WOMAC: ?MD=6.75; group B, NPRS: ?MD=0.75 and WOMAC: ?MD=11.12). In addition, significant mean differences (p<0.05) reported for both outcomes when we compared their scores between groups A and B at 2 weeks (?MD: NPRS=0.69; WOMAC=10.87) and 4 weeks post-intervention (?MD: NPRS=0.31; WOMAC=8.00). Furthermore, a post hoc Scheffe analysis for the outcomes NPRS and WOMAC revealed the superiority of group B over group A.
Conclusion: The specified manual therapies, in combination with a supervised exercise protocol, were found to be more effective than a supervised exercise protocol alone for improving pain and functional disability in patients with knee osteoarthritis.