Background Physical therapists provide a variety of interventions, such as manual therapy techniques, balance, coordination, and functional retraining techniques, knee taping techniques, electrical stimulation, and foot orthotics to assist in overcoming some of the barriers that make participation in exercise and physical activity difficult.
Objectives This study aimed to assess the role of physical therapy in management of knee osteoarthritis on both levels pain and function.
Methods Retrospective longitudinal study done on the department of Physical and Rehabilitation Medicine of the Principal Military Hospital of Tunis between January 2011 and December 2012, about 60 patients with knee OA. These patients were divided into two groups of 30 cases: patients aged 65 years and over (SA) and young adults 30 to 55 years (SJ). The evaluation protocol included clinical algofunctional before and after medical and rehabilitative treatment performed on an outpatient program with three sessions per week for two months.
Results There were 35 women and 25 men with a mean age of 58±6.27 years. The average duration of knee OA was 63.74±38.62 months. The main characteristics of elderly subjects compared to young subjects, before rehabilitation, were the bilateral involvement of the knees (p=0.02), severity of pain (p=0.02), disability (p=0.006), stiffness (p=0.02), muscle weakness of the quadriceps (p=0.006), hamstrings (p=0.03), the retraction of the latter (p=0.04) and reducing the walking distance (p=0.04). 38 patients (19 and 19 SA SJ) adhered to the rehabilitation program. After rehabilitation, the main features were the reduction of pain by 60%, improving activities of daily life of 50%. The rehabilitative treatment was more effective in the elderly in terms of pain (p=0.03) and activities of daily living improvement (p=0.01).
Patients in both groups improved their scores with no significant differences related to age. Considering respectively the VAS pain (p=0.48), WOMAC index (p=0.39) and LEQUESNE Index (p=0.75).
At the end of the rehabilitation program, a reduction in pain intensity was observed in all AS (19 cases), 13 of them have lowered their VAS pain threshold of less than 50 mm.
In young subjects, the pain remained stationary in 2 cases and was exacerbated in one case.
Conclusions Physical therapy appears to be an important tool for KOA management. Future studies are needed to improve our understanding of factors that can influence the responsiveness of patients with knee osteoarthritis to exercise and physical activity programs.
Disclosure of Interest None declared