PMID- 24421635
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140114
LR  - 20211021
IS  - 1066-9817 (Print)
IS  - 2042-6186 (Electronic)
IS  - 1066-9817 (Linking)
VI  - 21
IP  - 4
DP  - 2013 Nov
TI  - Manual physical therapy and perturbation exercises in knee osteoarthritis.
PG  - 220-8
LID - 10.1179/2042618613Y.0000000039 [doi]
AB  - OBJECTIVES: Knee osteoarthritis (OA) causes disability among the elderly and is 
      often associated with impaired balance and proprioception. Perturbation exercises 
      may help improve these impairments. Although manual physical therapy is generally 
      a well-tolerated treatment for knee OA, perturbation exercises have not been 
      evaluated when used with a manual physical therapy approach. The purpose of this 
      study was to observe tolerance to perturbation exercises and the effect of a 
      manual physical therapy approach with perturbation exercises on patients with 
      knee OA. METHODS: This was a prospective observational cohort study of 15 
      patients with knee OA. The Western Ontario and McMaster Universities Arthritis 
      Index (WOMAC), global rating of change (GROC), and 72-hour post-treatment 
      tolerance were primary outcome measures. Patients received perturbation balance 
      exercises along with a manual physical therapy approach, twice weekly for 4 
      weeks. Follow-up evaluation was done at 1, 3, and 6 months after beginning the 
      program. RESULTS: Mean total WOMAC score significantly improved (P = 0.001) after 
      the 4-week program (total WOMAC: initial, 105; 4 weeks, 56; 3 months, 54; 6 
      months, 57). Mean improvements were similar to previously published trials of 
      manual physical therapy without perturbation exercises. The GROC score showed a 
      minimal clinically important difference (MCID)>/=+3 in 13 patients (87%) at 4 
      weeks, 12 patients (80%) at 3 months, and 9 patients (60%) at 6 months. No 
      patients reported exacerbation of symptoms within 72 hours following each 
      treatment session. DISCUSSION: A manual physical therapy approach that also 
      included perturbation exercises was well tolerated and resulted in improved 
      outcome scores in patients with knee OA.
FAU - Rhon, Daniel
AU  - Rhon D
AD  - Madigan Army Medical Center, Department of Physical Medicine, Tacoma, WA, USA.
FAU - Deyle, Gail
AU  - Deyle G
AD  - Brooke Army Medical Center, San Antonio, TX, USA.
FAU - Gill, Norman
AU  - Gill N
AD  - Brooke Army Medical Center, San Antonio, TX, USA.
FAU - Rendeiro, Daniel
AU  - Rendeiro D
AD  - Occupational and Physical Therapy Service, Warrior Transition Brigade, Fort Hood, 
      TX, USA.
LA  - eng
PT  - Journal Article
PL  - England
TA  - J Man Manip Ther
JT  - The Journal of manual & manipulative therapy
JID - 9433812
PMC - PMC3822322
OTO - NOTNLM
OT  - Knee osteoarthritis
OT  - Manual therapy
OT  - Perturbation exercises
OT  - Physical therapy
EDAT- 2014/01/15 06:00
MHDA- 2014/01/15 06:01
PMCR- 2014/11/01
CRDT- 2014/01/15 06:00
PHST- 2014/01/15 06:00 [entrez]
PHST- 2014/01/15 06:00 [pubmed]
PHST- 2014/01/15 06:01 [medline]
PHST- 2014/11/01 00:00 [pmc-release]
AID - 139 [pii]
AID - 10.1179/2042618613Y.0000000039 [doi]
PST - ppublish
SO  - J Man Manip Ther. 2013 Nov;21(4):220-8. doi: 10.1179/2042618613Y.0000000039.