Supervised Exercise Therapy For Knee Pain Is Better Than Usual Care

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Supervised Exercise Therapy For Knee Pain Is Better Than Usual Care

http://www.medicalnewstoday.com/articles/168077.php

A study published today on bmj.com reports that supervised exercise therapy is

more effective at reducing pain and improving function than usual care for

patients with severe knee pain.

Knee pain is a common reason to visit the doctor. Patellofemoral pain syndrome

is a condition in which pain occurs at the front of the knee during or after

exercise. Symptoms usually start during adolescence when participation in

sporting activities is high. Also, women are more likely to be affected than

men.

General medical advice is to rest during periods of pain and to avoid pain

provoking activities. This " wait and see " approach is considered as standard

care.

The findings of a recent study suggest there is limited evidence on the

effectiveness of exercise therapy with respect to pain reduction. There are

inconsistent facts with respect to functional improvement.

In order to find out more, researchers based in the Netherlands investigated the

effectiveness of supervised exercise therapy. They compared it with usual care

in 131 patients aged between 14 and 40 years with patellofemoral pain syndrome.

From the total of 131 participants included in the study, 65 were assigned to a

supervised exercise program (intervention group) and 66 to usual care (control

group). Both groups received similar written information about the syndrome and

similar instructions for home exercises. All participants were instructed to

refrain from painful activities.

At the start of the study, patients rated their recovery, pain at rest, pain on

activity, and function scores. They did so again after three and twelve months.

After three months, the intervention group reported considerably less pain and

better function than the control group. At twelve months, the intervention group

continued to show superior outcomes than the control group with regard to pain

at rest and pain on activity, but not function.

A higher proportion of patients in the exercise group than in the control group

reported recovery (42 percent compared to 35 percent at three months and 62

percent compared to 51 percent at twelve months). However, these results were

not considerably different between the two groups.

The authors say that the findings of this study give indication that supervised

exercise therapy for patellofemoral pain syndrome in general practice is more

effective than usual care for pain at rest, pain on activity, and function at

three and twelve months. On the other hand, supervised exercise therapy had no

effect on perceived recovery.

They say in closing that further research is necessary in order to understand

how exercise therapy results in better outcome.

" Supervised exercise therapy versus usual care for patellofemoral pain syndrome:

an open label randomized controlled trial "

R van Linschoten, sports physician, M van Middelkoop, researcher, M Y Berger,

researcher, general practitioner, E M Heintjes, research associate, J A N

Verhaar, professor of orthopaedics, S P Willemsen, statistician, B W Koes,

research professor, S M Bierma-Zeinstra, associate research professor

BMJ 2009; 339:b4074

doi:10.1136/bmj.b4074

bmj.com