TUESDAY, Nov. 6 (HealthDay News) -- Adults with painful
osteoarthritis of the knee should turn to exercise -- aerobic,
aquatic or strength training -- as a good nonsurgical way to ease
their pain and improve their functioning, a new review
To reach this conclusion, Dr. Tatyana Shamliyan, a senior
research associate at the University of Minnesota, and her
colleagues reviewed 193 studies that were published between 1970
"Several guidelines recommend nondrug treatment, including exercise, electrical stimulation, tai chi and esthetics," Shamliyan said. Her team analyzed the evidence and came up with results that were sometimes at odds with those guidelines.
They looked at how the therapies affected pain, functioning and
"Based on the analysis, we can't conclude sustained benefit with tai chi, manual therapy or massage, or transcutaneous electrical [nerve] stimulation," she said.
The electrical stimulation reduced pain, she found, for very
short time periods, less than six weeks. Over time, the pain
actually got worse, she noted.
The investigators found few physical therapy interventions
worked to reduce pain or improve functioning or levels of
Shamliyan said it's important for those with knee pain from
osteoarthritis -- the "wear-and-tear" form -- get a prescriptive
exercise program of aerobics, aquatics or strength training from a
The research is published in the Nov. 6 issue of the
Annals of Internal Medicine.
In the analysis, the researchers also found that perseverance
counted. "We found some evidence that adherence, compliance with
the exercise recommended was associated with better outcomes," she
However, the study authors did not find good evidence that more
intense exercise was any better than moderate exercise.
The U.S. Agency for Healthcare Research and Quality funded the
Osteoarthritis of the knee affects about 28 percent of those
older than 45 in the United States, the study authors said, and 37
percent of those over 65.
Nonsurgical treatments are aimed at reducing or controlling
pain, helping physical functioning, preventing disability and
improving quality of life.
The findings are no surprise to Dr. Benjamin Bengs, an assistant
professor of orthopedic surgery at UCLA Medical Center, Santa
Monica, and the University of California, Los Angeles, David Geffen
School of Medicine.
"There is evidence to show that physical therapy, aerobic and aquatic exercise and strength training all improve quality of life," he said.
The researchers also showed that certain therapies were not
effective, Bengs noted, although he would not discount them so
quickly. "Given the potential for placebo effect, I would not rule
out these [other treatments]," he added.
Often, Bengs said, his patients will be convinced a treatment
that has no science to back it up is helping them. If it does, and
it's not harmful, he doesn't see a problem.
He did suggest that some of the nonsurgical treatments work
better when done in tandem with surgery.
And, Bengs agreed that people do better when they adhere to the
exercise program prescribed for them.
Both Bengs and Shamliyan also advised maintaining a healthy
weight to improve knee pain.
To learn more about knee pain, visit the
U.S. National Library of Medicine.
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