Reviewed by Kirsten Hales, SPT
Introduction
Knee osteoarthritis (OA) is a prevalent musculoskeletal condition, commonly leading to pain, stiffness, and functional limitations, especially in older adults. While pharmacological treatments like pain relievers and anti-inflammatory medications are frequently used, non-pharmacological approaches such as physical therapy are essential for long-term management. The article “Well-Tolerated Strategies for Managing Knee Osteoarthritis: A Manual Physical Therapist Approach to Activity, Exercise, and Advice,” by Deyle and Gill (2012), explores manual physical therapy, exercise, and patient education as effective strategies for managing knee OA symptoms. This review aims to evaluate the article’s key findings and contributions to knee OA management.
Methods
The article provides a comprehensive overview of evidence-based strategies for managing knee OA. The authors reviewed multiple studies and clinical evidence to support the effectiveness of manual therapy, exercise, and patient education. These strategies were analyzed for their ability to alleviate pain, improve joint mobility, and enhance overall function in individuals with knee OA.The article highlights the best practices for physical therapists, covering exercise recommendations, manual therapy techniques, and behavioral changes.
Results
- Manual Therapy: The use of joint mobilizations and soft tissue techniques was shown to reduce pain and increase mobility in patients with knee OA. The authors emphasized that manual therapy could provide immediate symptomatic relief and improve range of motion when combined with other interventions.
- Exercise Therapy: A combination of strengthening exercises for the quadriceps and aerobic activities was identified as crucial for reducing pain and improving functional outcomes. The article mentioned that exercises should be customized to each patient’s needs, with a focus on gradual progression to prevent worsening symptoms.
- Patient Education: Teaching patients about the importance of staying active, modifying daily activities to minimize joint strain, and incorporating weight management strategies were key components of successful treatment.
- Progressive Load Management: The article discussed the importance of increasing exercise intensity over time, ensuring patients do not overload the joint but are progressively challenged to improve strength and function.
Discussion
The authors concluded that a combination of manual therapy, exercise, and patient education provides a well-rounded, effective approach to managing knee OA. Manual therapy helps reduce immediate pain and stiffness, while exercise promotes long-term improvements in joint function and strength. The authors also highlighted the critical role of patient education in helping individuals manage their condition, maintain physical activity, and prevent further joint degeneration.
However, the authors also noted some limitations. While the evidence supports the benefits of these interventions, they acknowledged that more research is needed to determine the most effective protocols for specific patient populations, including those with varying levels of severity in OA. The differences in exercise routines and manual therapy techniques across studies makes it challenging to create a standardized treatment protocol.
Conclusion
The article provided strong evidence for the efficacy of manual therapy, exercise, and patient education in managing knee OA. For clinicians, it serves as a valuable resource in developing treatment plans that emphasize non-invasive, well-tolerated interventions. Incorporating these strategies into rehabilitation programs can significantly improve outcomes for patients with knee OA. As a student physical therapist, I have observed the positive impact of combining these approaches in clinical practice. The focus on individualized care is particularly important, as knee OA affects patients in many different ways. However, like the authors, I believe more research is needed to determine optimal exercise protocols and to assess long-term outcomes. In the meantime, the comprehensive approach outlined in this article is an excellent foundation for treating knee OA in clinical settings.
Reference
Deyle, G. D., & Gill, N. W. (2012). Well-Tolerated Strategies for Managing Knee Osteoarthritis: A Manual Physical Therapist Approach to Activity, Exercise, and Advice. The Physician and Sportsmedicine, 40(3), 12–25. https://doi.org/10.3810/psm.2012.09.1976