Non-Aggressive Treatment in Knee Osteoarthritis Patients: A Literature Review
Abstract
Introduction: High prevalence of knee osteoarthritis (OA) in Iran and the subsequent disability have resulted in representing multifarious non-aggressive interventions with distinct influences on the disease. The aim of this study was to review previous domestic studies about the effects of conservative therapeutic options on patients with knee OA.
Materials and Methods: Using search engines involving IranMedex, MedLib, ISC, Google Scholar, Magiran, SID, rehabilitation, and medical journals based on defined keywords, 98 Persian language articles were found, and 37 studies were finally included in our study after applying the exclusion criteria. The type of study, the pattern of choosing subjects, patient information, the measurements, interventions, and the results were exploited from each article, and the physiotherapy evidence database (PEDro) scale was administrated to evaluate the studies.
Results: Based on analysis of PEDro scale results (Mean±SD for articles score: 5.89±1.29), the quality of most articles was as fair and good. The focus of conservative treatments was on exercise therapy methods, assistive devices, and physical therapy management. From a clinical perspective, the evidence indicates the appropriate effects of such treatment choices on alleviating pain, enhancing function, and improving quality of life in individuals with knee OA.
Conclusion: Most conservative methods can reduce pain, and improve quality of life and physical performance in patients with knee OA. However, further high-quality studies with larger sample sizes and long-term follow-ups are required to determine whether knee OA can be managed by conservative methods.
Mazloum V, Rahnama N, Khayambashi K. Effects of therapeutic exercise and hydrotherapy on pain severity and knee range of motion in patients with hemophilia: A randomized controlled trial. International Journal of Preventive Medicine. 2014; 5(1):83-8. [PMID]
Rahnama N, Mazloum V. Effects of strengthening and aerobic exercises on pain severity and function in patients with knee rheumatoid arthritis. International Journal of Preventive Medicine. 2012; 3(7):493-8. [PMID]
Luyten FP, Denti M, Filardo G, Kon E, Engebretsen L. Definition and classification of early osteoarthritis of the knee. Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA. 2012; 20(3):401-6. [DOI:10.1007/s00167-011-1743-2] [PMID]
Schiphof D, Kerkhof HJ, Damen J, de Klerk BM, Hofman A, Koes BW, et al. Factors for pain in patients with different grades of knee osteoarthritis. Arthritis Care & Research. 2013; 65(5):695-702. [DOI:10.1002/acr.21886] [PMID]
Nguyen US, Zhang Y, Zhu Y, Niu J, Zhang B, Felson DT. Increasing prevalence of knee pain and symptomatic knee osteoarthritis: Survey and cohort data. Annals of Internal Medicine. 2011; 155(11):725-32. [DOI:10.7326/0003-4819-155-11-201112060-00004] [PMID] [PMCID]
Silverwood V, Blagojevic-Bucknall M, Jinks C, Jordan L, Protheroe J, Jordan K. Current evidence on risk factors for knee osteoarthritis in older adults: A systematic review and meta-analysis. Osteoarthritis and Cartilage. 2015; 23(4):507-15. [DOI:10.1016/j.joca.2014.11.019] [PMID]
Lee R, Kean W. Obesity and knee osteoarthritis. Inflammopharmacology. 2012; 20(2):53-8. [DOI:10.1007/s10787-011-0118-0] [PMID]
Roos EM. Joint injury causes knee osteoarthritis in young adults. Current Opinion in Rheumatology. 2005; 17(2):195-200. [DOI:10.1097/01.bor.0000151406.64393.00] [PMID]
Michael JW, Schlüter-Brust KU, Eysel P. The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee. Deutsches Arzteblatt International. 2010; 179(9):152-62. [DOI:10.3238/arztebl.2010.0152] [PMID] [PMCID]
Dahaghin S, Tehrani-Banihashemi SA, Faezi ST, Jamshidi AR, Davatchi F. Squatting, sitting on the floor, or cycling: Are life-long daily activities risk factors for clinical knee osteoarthritis? Stage III results of a community-based study. Arthritis and Rheumatism. 2009; 61(10):1337-42. [DOI:10.1002/art.24737] [PMID]
Mohammadi F, Taghizadeh S, Ghaffarineh F, Khorrami M, Sobhani S. Proprioception, dynamic balance and maximal quadriceps strength in females with knee osteoarthritis and normal control subjects. International Journal of Rheumatic Diseases. 2008; 11(1):39-44. [DOI:10.1111/j.1756-185X.2008.00328.x]
Kon E, Filardo G, Drobnic M, Madry H, Jelic M, van Dijk N, et al. Non-surgical management of early knee osteoarthritis. Knee Surgery, Sports Traumatology, Arthroscopy. 2012; 20(3):436-49. [DOI:10.1007/s00167-011-1858-5] [PMID]
Weinstein AM, Rome BN, Reichmann WM, Collins JE, Burbine SA, Thornhill TS, et al. Estimating the burden of total knee replacement in the United States. The Journal of Bone and Joint Surgery. 2013; 95(5):385-92. [DOI:10.2106/JBJS.L.00206] [PMID] [PMCID]
Lafta Mezaal A, Bashardoust Tajali S, Olyaei G, Jalaie S, Thweab Alwatifi S. Effects of low-level laser versus laser acupuncture in patients with knee osteoarthritis: A randomized controlled trial. Journal of Modern Rehabilitation. 2019; 12(3):183-94. [Link]
Roody E, Zhang W, Doherty M. Aerobic walking or strengthening exercise for osteoarthritis of the knee? A systematic review. Annals of Rheumatic Diseases. 2005; 64(4):544-8. [DOI:10.1136/ard.2004.028746] [PMID] [PMCID]
Fransen M, McConnell S, Harmer AR, Van der Esch M, Simic M, Bennell KL. Exercise for osteoarthritis of the knee: A Cochrane systematic review. British Journal of Sports Medicine. 2015; 49(24):1554-7. [PMID]
Wallis JA, Taylor NF. Pre-operative interventions (non-surgical and non-pharmacological) for patients with hip or knee osteoarthritis awaiting joint replacement surgery - a systematic review and meta-analysis. Osteoarthritis and Cartilage. 2011; 19(12):1381-95. [DOI:10.1016/j.joca.2011.09.001] [PMID]
Bennell KL, Hinman RS. A review of the clinical evidence for exercise in osteoarthritis of the hip and knee. Journal of Science and Medicine in Sport. 2011; 14(1):4-9. [DOI:10.1016/j.jsams.2010.08.002] [PMID]
Pinto D, Robertson MC, Hansen P, Abbott JH. Cost-effectiveness of nonpharmacologic, nonsurgical interventions for hip and/or knee osteoarthritis: Systematic review. Value in Health. 2012; 15(1):1-12. [DOI:10.1016/j.jval.2011.09.003] [PMID]
Maher CG, Moseley AM, Sherrington C, Elkins MR, Herbert RD. A description of the trials, reviews, and practice guidelines indexed in the PEDro database. Physical Therapy. 2008; 88(9):1068-77. [DOI:10.2522/ptj.20080002] [PMID]
Lange AK, Vanwanseele B, Fiatarone Singh MA. Strength training for treatment of osteoarthritis of the knee: A systematic review. Arthritis Care and Research. 2008; 59(10):1488-94. [DOI:10.1002/art.24118] [PMID]
Warden SJ, Hinman RS, Watson MA Jr, Avin KG, Bialocerkowski AE, Crossley KM. Patellar taping and bracing for the treatment of chronic knee pain: A systematic review and meta-analysis. Arthritis and Rheumatism. 2008; 59(1):73-83. [DOI:10.1002/art.23242] [PMID]
Rafsanjani-Dehghazi H, Kalantari K, Rezasoltani A, Sadat Naimi S, Akbarzadeh Baghban A, Tavakoli S, et al. [The acute effect of common proneal nerve electrical stimulation on maximum capacity of quadriceps activation in patients with knee osteoarthritis (Persian)]. The Scientific Journal of Rehabilitation Medicine. 2016; 5(2):61-8. [Link]
Moezy A, Nejati P, Mazaherinezhad A. [The effects of high intensity Nd: YAG laser on pain and function in patients with knee osteoarthritis (Persian)]. Journal of Isfahan Medical School. 2018; 36(473):299-308. [DOI:10.22122/JIMS.V36I473.9315]
Shah Hosseini G, Negahban Siuki H, Madani S, Ebrahimi Takamjani E, Shaterzadeh M. [Comparison of the effect of two therapeutic methods (traditional & new) on therapeutic parameters in patients with primary knee osteoarthritis (Persian)]. Razi Journal of Medical Sciences. 2004; 10(37):735-41. [Link]
Yalfani A, Naderi E, Shayesterudi Y. [Comparing the effectiveness of hydrotherapy and physiotherapy in the management of knee osteoarthritis (Persian)]. Journal of Research in Rehabilitation Sciences. 2012; 8(2):328-36. [Link]
Tavakoli M, Bahrpeyma F. [The effect of mobilization on improvement of physical function in knee osteoarthritis (Persian)]. Journal of Kermanshah University of Medical Sciences. 2011; 15(1):13-7. [Link]
Erfani M, Mehrabian H, Shojaedin S, Sadeghi H. [Effects of pilates exercise on knee osteoarthritis in elderly male athletes (Persian)]. Journal of Research in Rehabilitation Sciences. 2012; 7(4):571-9. [Link]
Barati S, Khayambashi K, Rahnama N, Nayeri M. [Effect of a selected core stabilization training program on pain and function of the females with knee osteoarthritis (Persian)]. Journal of Research in Rehabilitation Sciences. 2012; 8(1):40-8. [Link]
Ahmadi F, Forghany S, Nester C, Jones R. Effects of laterally wedged insoles on static balance in patients with medial compartment knee osteoarthritis. Journal of Research in Rehabilitation Sciences. 2014; 7(Suppl 1):A22. [PMCID]
Forough B, Emadifar R, Saeedi H, Ghasemi M. [Comparing the efficacy of a lateral - wedge insole with subtalar supporting and an in-shoe lateral - wedge in patients with varus deformity osteoarthritis of the knee (Persian)]. Journal of Gorgan University of Medical Sciences. 2007; 9(2):51-5. [Link]
Ahadi T, Saleki M, Razi M, Raeisi Gh, Forough B. [Comparison of physical modality and knee isometric exercise training on symptom of knee osteoarthritis (Persian)]. Journal of Gorgan University of Medical Sciences. 2011; 12(4):12-7. [Link]
Bagheri S, Fatemi E, Fazeli SH, Ghorbani R, Lashkari F. [Efficacy of low level laser on knee osteoarthritis treatment (Persian)]. Koomesh. 2011; 12(3):285-92. [Link]
Esfandiari E, Kamyab M, Foroughi N, Yazdi H. [The effect of lateral wedge insole with and without sub-talar strap on pain, function, and quality of life in medial knee osteoarthritis (Persian)]. Modern Rehabilitation. 2012; 6(1):17-25. [Link]
Fatemy E, Bakhtiyari A, Alizadeh A, Ghasemi F, Mahmoudi S, Ghorbani R. [The effect of swedish massage on knee osteoarthritis (Persian)]. Journal of Artesh University of Medical Sciences. 2010; 8(3):200-4. [Link]
Mazloum V, Rahnama N. [Comparison of the effects of therapeutic exercise and pilates training on function and proprioception in patients with knee osteoarthritis: A randomized controlled trial (Persian)]. Archives of Rehabilitation. 2014; 15(1):53-62. [Link]
Mahmoodi Aghdam S, KhademiKalantari K, Akbarzadeh Baghban AR, Rezayi M, Rahimi A, Naimee SS. [Effect of sustained traction on physical improvements of patients with severe knee osteoarthritis (Persian)]. Journal of Modern Rehabilitation. 2013; 7(3):24-31. [Link]
Mazloum V, Sobhani V, Shirvani H, Khatibiaghda A. [A comparative study on the influence of kinesio taping® and laser therapy on knee joint position sense, pain intensity, and function in individuals with knee osteoarthritis (Persian)]. Journal of Shahrekord University of Medical Sciences. 2016; 18(5):103-14. [Link]
Taghizade Delkhosh C, Fatemy E, Ghorbani R, Mohammadi R. [Comparing the immediate and long-term effects of low and high power laser on the symptoms of knee osteoarthritis (Persian)]. Journal of Mazandaran University of Medical Sciences. 2018; 28(165):69-77. [Link]
Bagheri S, Shojaedin S, Naderi A, Hosseini H, Nikoo MR. [Comparing two therapeutic methods of hip abductor-quadriceps strengthening and quadriceps strengthening alone on pain and function in women with knee osteoarthritis (Persian)]. Anesthesiology and Pain. 2016; 6(4):46-55. [Link]
Ezadpanah A, Moazami M, Khoshraftar Yazdi N. [Effect of a period of therapeutic exercise and detraining after that on balance in the women with knee osteoarthritis (Persian)]. Journal of Modern Rehabilitation. 2016; 9(1):101-9. [Link]
Pouradeli H, Sadeghi H, Sokhangouei Y, Azarbayjani MA. [Effect of electrotherapy and strength training of selected lower limb muscles on pain and balance in elderly women with knee osteoarthritis with emphasis on the type of focus of attention (Persian)]. Scientific Journal of Rehabilitation Medicine. 2021; 9(4):289-97. [Link]
Etesami A S, Zamani J, Zolaktaf V, Ghasemi G. [Effectiveness of aquatic exercise therapy on quality of life in women with knee osteoarthritis (Persian)]. Iranian Journal of Ageing. 2016; 10(38):62-71. [Link]
Attari E, Arab-Ameri E, Tahmasebi-Brojeni S. [The comparison of effects between Tai Chi exercise and glucosamine supplementation on balance in older woman with knee osteoarthritis (Persian)]. Journal of Research in Rehabilitation Sciences. 2018; 13(5):247-54. [Link]
Abdollahi A, Goodarzi B, Shakoori SK. [The effect of isokinetic training on pain and function in patients with knee osteoarthritis: Clinical traial (Persian)]. Medical Journal of Tabriz University of Medical Science & Health Service. 2019; 41(1):56-64. [DOI:10.34172/mj.2019.007]
Jamali Masoomi S, Khoshraftar Yazdi N, Rashidlamir A, Rezaie Yazdi Z. [The effect of pilates trainings on pain intensity and indicators of balance in the female with knee osteoarthritis (Persian)]. Journal of Paramedical Sciences & Rehabilitation. 2019; 8(1):101-8. [Link]
Mohsenipour SM, Ravanbod R, Torkaman G, Bayat N. [The effects of pulsed ultrasound on postural sway in women with knee osteoarthritis: A randomized clinical trial (Persian)]. Journal of Research in Rehabilitation Sciences. 2018; 14(1):40-7. [Link]
Kamali Sarvestani F, Moslemi Haghighi F, Abolharari Shirazi S, Amirian S, Haghighat F. [Comparison of manual therapy and taping in knee osteoarthritis (Persian)]. Journal of Research in Rehabilitation Sciences. 2012; 7(3):241-9. [Link]
Mehrabian H, Shojaedin S, Baratii A, Ghasemi M. [Effects of aquatic exercise on the pain, symptoms, motor performance and quality of life of elderly women with knee osteoarthritis (Persian)]. Journal of Research in Rehabilitation Sciences. 2012; 8(2):337-45. [Link]
Malekzadeh M, Ghasemi B, Mirnasuri R. [Effect of aquatic exercises on the motor performance and the quality of life in patients with knee joint osteoarthritis (Persian)]. Hormozgan Medical Journal. 2014; 18(3):211-8. [Link]
Rahimi A, Mohammad Hossein F, Delnavaz M. [A comparative study on the action potential simulation (APS) therapy and the routine physiotherapy protocol in knee osteoarthritisin elderly people (Persian)]. Scientific Journal of Rehabilitation Medicine. 2012; 1(1):22-34. [Link]
Roustaei M, Hasanzadeh K, RezaSoltani A. [A survey on the effects of iontophoresis of piroxicam gel on pain and knee muscles strength patients with knee osteoarthritis (Persian)]. Scientific Journal of Rehabilitation Medicine. 2012; 1(1):35-43. [Link]
Khademi Kalantari K, Zahedi A, Rahmani S, Bozari S, Rezaei M. [A comparison between the immediate effects of two “Three Pressure Points” and “Neopran” knee orthosis in pain reduction and functional improvement of patients with medial compartment knee osteoarthritis (Persian)]. Journal of Modern Rehabilitation. 2009; 2(3-4):1-5. [Link]
Majdoleslami B, Mousavi S M E, Safari M R, Rahgozar M. [Influence of elastic bandage and neoprene sleeve on knee position sense and pain in subjects with knee osteoarthritis (Persian)]. Archives of Rehabilitation. 2004; 4(3):40-4. [Link]
Zarei P, Rahnama N. [Comparison of the effects of the two strengthening and balanced, strengthening, balanced, and core-stability exercise protocols on the balance and fear of falling in women with knee osteoarthritis (Persian)]. Journal of Paramedical Science and Rehabilitation. 2018; 7(2):43-54. [Link]
Kazemi AR, Ghasemi B, Moradi MR. [Comparison of two methods of physiotherapy-reflexology of foot and physiotherapy on symptoms of senile patients with knee osteoarthritis (Persian)]. Journal of Isfahan Medical School. 2015; 33(350):1517-29. [Link]
Hassani Haghighi F, Hashemi Javaheri A, Ariamanesh A, Khoshraftar Yazdi N. [Effect of aquatic exercise therapy on the quadriceps muscle electromyography and pain in women with knee osteoarthritis (Persian)]. Journal of Paramedical Science and Rehabilitation. 2016; 5(2):42-50. [Link]
Kamali M, Sharifmoradi K, Karimi M, Tahmasebi A. [The effect of a medical insole with arch support and lateral wedge on the adductor moment of the knee joint in patients with medial knee osteoarthritis (Persian)]. Journal of Paramedical Sciences & Rehabilitation. 2016; 5(4):7-15. [Link]
Safari Bak M, Khoshraftar Yazdi N, Aghajani A. [The effect of eight weeks selected exercises on balance indexes in elderly patients with knee osteoarthritis (Persian)]. Journal of Paramedical Science and Rehabilitation. 2017; 6(2):86-97. [Link]
Silva LE, Valim V, Pessanha AP, Oliveira LM, Myamoto S, Jones A, et al. Hydrotherapy versus conventional land-based exercise for the management of patients with osteoarthritis of the knee: A randomized clinical trial. Physical Therapy. 2008; 88(1):12-21. [DOI:10.2522/ptj.20060040] [PMID]
Roper JA, Bressel E, Tillman MD. Acute aquatic treadmill exercise improves gait and pain in people with knee osteoarthritis. Archives of Physical Medicine and Rehabilitation. 2013; 94(3):419-25. [DOI:10.1016/j.apmr.2012.10.027] [PMID]
Ansari S, Elmieh A, Hojjati Z. Effects of aquatic exercise training on pain, symptoms, motor performance, and quality of life of older males with knee osteoarthritis. Annals of Applied Sport Science. 2014; 2(2):29-38. [DOI:10.18869/acadpub.aassjournal.2.2.29]
Bryan M, Hawson S. The benefits of pilates exercise in orthopaedic rehabilitation. Techniques in Orthopaedics. 2003; 18(1):126-9. [DOI:10.1097/00013611-200303000-00018]
Cuğ M, Ak E, Ozdemir RA, Korkusuz F, Behm DG. The effect of instability training on knee joint proprioception and core strength. Journal of Sports Science and Medicine. 2012; 11(3):468-74. [PMID]
Granacher U, Gollhofer A, Hortobágyi T, Kressig RW, Muehlbauer T. The importance of trunk muscle strength for balance, functional performance, and fall prevention in seniors: A systematic review. Sports Medicine. 2013; 43(7):627-41. [DOI:10.1007/s40279-013-0041-1] [PMID]
Toda Y, Segal N. Usefulness of an insole with subtalar strapping for analgesia in patients with medial compartment osteoarthritis of the knee. Arthritis and Rheumatism. 2002; 47(5):468-73. [DOI:10.1002/art.10669] [PMID]
Kuroyanagi Y, Nagura T, Matsumoto H, Otani T, Suda Y, Nakamura T, et al. The lateral wedged insole with subtalar strapping significantly reduces dynamic knee load in the medial compartment gait analysis on patients with medial knee osteoarthritis. Osteoarthritis and Cartilage. 2007; 15(8):932-6. [DOI:10.1016/j.joca.2007.02.004] [PMID]
Bijlsma J, Knahr K. Strategies for the prevention and management of osteoarthritis of the hip and knee. Best Practice and Research Clinical Rheumatology. 2007; 21(1):59-76. [DOI:10.1016/j.berh.2006.08.013] [PMID]
Deyle GD, Henderson NE, Matekel RL, Ryder MG, Garber MB, Allison SC. Effectiveness of manual physical therapy and exercise in osteoarthritis of the knee: A randomized, controlled trial. Annals of Internal Medicine. 2000; 132(3):173-81. [DOI:10.7326/0003-4819-132-3-200002010-00002] [PMID]
Suraj VP, Kumar S. Effect of knee complex mobilization on pain and active range of motion arc in osteoarthritis knee joint. Physical Therapy in Sport. 2006; 7(4):176. [DOI:10.1016/j.ptsp.2006.09.012]
Campolo M, Babu J, Dmochowska K, Scariah S, Varughese J. A comparison of two taping techniques (kinesio and mcconnell) and their effect on anterior knee pain during functional activities. International Journal of Sports Physical Therapy. 2013; 8(2):105-10. [PMID]
Mazloum V, Mahdavinejad R. [Effects of Swedish massage techniques and therapeutic exercise on patellofemoral pain syndrome (Persian)]. Journal of Research in Rehabilitation Sciences. 2012; 8(2):363-71. [Link]
Jane SW, Wilkie DJ, Gallucci BB, Beaton RD, Huang HY Effects of a full-body massage on pain intensity, anxiety, and physiological relaxation in Taiwanese patients with metastatic bone pain: A pilot study. Journal of Pain and Symptom Management. 2009; 37(4):754-63. [DOI:10.1016/j.jpainsymman.2008.04.021] [PMID]
Lee YH, Park BN, Kim SH. The effects of heat and massage application on autonomic nervous system. Yonsei Medical Journal. 2011; 52(6):982-9. [DOI:10.3349/ymj.2011.52.6.982] [PMID] [PMCID]
Astephen Wilson JL, Deluzio KJ, Dunbar MJ, Caldwell GE, Hubley-Kozey CL. The association between knee joint biomechanics and neuromuscular control and moderate knee osteoarthritis radiographic and pain severity. Osteoarthritis and Cartilage. 2011; 19(2):186-93. [DOI:10.1016/j.joca.2010.10.020] [PMID]
Mesfar W, Shirazi-Adl A. Biomechanics of the knee joint in flexion under various quadriceps forces. The Knee. 2005; 12(6):424-34. [DOI:10.1016/j.knee.2005.03.004] [PMID]
Owoeye I, Spielholz NI, Fetto J, Nelson AJ. Low-intensity pulsed galvanic current and the healing of tenotomized rat achilles tendons: A preliminary report using load-to- breaking measurements. Archives of Physical Medicine and Rehabilitation. 1987; 68(7):415-8. [PMID]
Papendorp D, Van H, Joubert A, Koorts A. A comparative study between a DC, MET electrical field (APS therapy) and conventional TENS on ATP levels in an in vitro system. Biomedical Research. 2002; 26(6):249-53.
Alfredo PP, Bjordal JM, Dreyer SH, Meneses SR, Zaguetti G, Ovanessian V, et al. Efficacy of low level laser therapy associated with exercises in knee osteoarthritis: A randomized double-blind study. Clinical Rehabilitation. 2012; 26(6):523-33. [DOI:10.1177/0269215511425962] [PMID]
| Files | ||
| Issue | Vol 17 No 3 (2023) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/jmr.v17i3.13064 | |
| Keywords | ||
| Knee osteoarthritis Conservative treatments Exercise therapy Physical therapy Pain Function | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
