Physical Therapy Appears to Be Best Answer for
Senior Citizens with Knee Osteoarthritis
New study offers hope to persons with osteoarthritis
who want to avoid the toll of surgery
Sept.
12, 2008 - A new study questioning the usefulness of arthroscopic
surgery for osteoarthritis of the knee should encourage patients to
consider physical therapy as an effective non-surgical option, according
to the American Physical Therapy Association (APTA). This is a common
problem for senior citizens and a recent study found about half will
suffer with osteoarthritis of the knee if they live until age 85.
The study, published yesterday in the New England
Journal of Medicine, found that physical therapy, combined with
comprehensive medical management, is just as effective at relieving the
pain and stiffness of moderate to severe osteoarthritis of the knee as
arthroscopic surgery.
"This study offers hope and encouragement to
persons with osteoarthritis who would like to avoid the pain and
emotional toll of surgery," said APTA President R Scott Ward, PT, PhD.
"Too often, the first line of defense is surgery
when it need not always be. Physical therapy can be equally effective
and should be considered by not only patients themselves, but also the
primary care doctors and orthopedists who are treating them."
"Many times knee pain is associated with abnormal
movement patterns that cause increased stress on the joint, says.
therapist Christopher M Powers, PhD, PT, director of the Biokinesiology
program and co-director of the Musculoskeletal Biomechanics Research Lab
at the University of Southern California Division of Biokinesiology &
Physical Therapy.
About the Arthritis Foundation Exercise Program
The Arthritis Foundation Exercise Program, formerly
known as People with Arthritis Can Exercise (PACE), is a program
developed by the Arthritis Foundation in 1987 to promote self-management
of arthritis through exercise.
The program is offered at basic and advanced
levels, and is available throughout the country in many convenient
community-based settings. A detailed listing of classes in local areas
can be found on the Arthritis Foundation's Web site at
www.arthritis.org.
Arthroscopic surgery does little to correct the
dynamic factors that may be contributing to knee pain and pathology.
These findings reinforce the need for a comprehensive treatment approach
for such patients."
The NEJM study adds to a growing body of evidence
supporting physical therapy for treatment of osteoarthritis of the knee,
including:
● A report published in the
January 2008 issue of the journal Physical Therapy that reviewed
research on osteoarthritis of the knee from 2000 to 2007 and found
"high-quality evidence that exercise and weight reduction reduce pain
and improve physical function."
That study also
found moderate-quality evidence that acupuncture,transcutaneous electrical nerve stimulation, and low-level lasertherapy
reduce pain and that psychoeducational interventionsimprove
psychological outcomes
● A study published in the
Feb 1, 2000 issue of the Annals of Internal Medicine that concluded
"a combination of manual physical therapy and supervised exercise yields
functional benefits for patients with osteoarthritis of the knee and may
delay or prevent the need for surgical intervention."
A physical therapist will perform a thorough
examination and design a plan of care that may include:
● A series of exercises designed to help improve
motion. Activities in this phase might include water walking, swimming,
and flexibility exercises.
● An exercise sequence to restore strength
including a functional progression, that is, a gradual return to normal
activities using exercises that simulate the knee stresses of your
normal activities.
A knee's tolerance for stressful activities often
decreases with age and loss of conditioning. As a result, stresses that
would not have caused pain or injury to the knee last year could today.
A decrease in levels of activity over a period of time may also
contribute to the vulnerability of knees.
But there are steps one can take to help prevent
injury in order to continue enjoying sports and exercise. Pursuing an
exercise program designed by a physical therapist can be one of the best
protections from injury.
The first step in designing your exercise program
is an evaluation by your physical therapist. He or she can identify your
predisposing factors, those body traits that may make you more or less
vulnerable to a knee injury. Based on this evaluation, your physical
therapist can design a program that will help you gain your optimum
levels of function, strength and conditioning.
Physical therapy plays a key role in treating and
rehabilitating the knee, but the patient's attitude toward recovery
plays a big factor in achieving a successful outcome. For more
information on taking care of your knees and to find a physical
therapist, visit
www.apta.org/consumer.
APTA (www.apta.org) is a national organization
representing physical therapists, physical therapist assistants, and
students nationwide. Its goal is to foster advancements in physical
therapist education, practice, and research. Consumers can visit
www.findapt.us to find a physical therapist in their area, as well
as
www.apta.org/consumer for physical therapy news and information.
Arthritis Foundation Exercise Program (AFEP)
(formerly People with Arthritis Can exercise or PACE) is a
community-based recreational exercise program developed by the Arthritis
Foundation. Trained AFEP instructors cover a variety of range-of-motion
and endurance-building activities, relaxation techniques, and health
education topics. All of the exercises can be modified to meet
participant needs. The program's demonstrated benefits include improved
functional ability, decreased depression, and increased confidence in
one's ability to exercise. Classes typically meet two or three times per
week. To find about availability in your area you can check with the
Arthritis Foundation* or
view this map to locate your state arthritis program.
Active Living Everyday (ALED) is a
group-based program developed at the Cooper Institute focused on helping
sedentary people become and stay physically active. Participants (~20/grp)
come together for 1 hour weekly sessions for 20 weeks of classroom
instruction to learn behavioral skills (identifying and overcoming
barriers, setting goals, creating an action plan) needed to become more
physically active. A variety of moderate and vigorous physical
activities are discussed in the program, giving the background for
individuals to make their personal decisions about type, form,
frequency, intensity and dose. Participants do their actual activity
outside of the group setting. Facilitators (instructors) that teach the
course are trained and certified. A participant book is used in
conjunction with the course.
http://www.activeliving.info/.*
Arthritis Foundation Aquatic Program (AFAP)
is a water exercise program created by the Arthritis Foundation for
people with arthritis and related conditions. The classes are conducted
by a trained instructor and are designed to improve flexibility, joint
range of motion, endurance, strength, and daily function and to decrease
pain. The aquatics classes include joint range of motion, stretching,
breathing, and light aerobic activities. The classes typically meet two
or three times per week for one hour. To find out about availability in
your area you can check with the
Arthritis Foundation* or
view this map to locate your state arthritis program.
EnhanceFitness (EF) EnhanceFitness
(formerly Lifetime Fitness) is an evidence-based, community-delivered
exercise program proven to increase strength, boost activity levels and
elevate mood. Certified EF instructors offer a program that focuses on
stretching, flexibility, balance, low impact aerobics, and strength
training exercises. Typically classes meet three times a week for one
hour. To find out about availability in your area you can check with
your state arthritis program.
Use this map to locate your state arthritis program.
Keep up with the latest news for senior citizens, baby
boomers
Sept.
12, 2008 - A new study questioning the usefulness of arthroscopic
surgery for osteoarthritis of the knee should encourage patients to
consider physical therapy as an effective non-surgical option, according
to the American Physical Therapy Association (APTA). This is a common
problem for senior citizens and a recent study found about half will
suffer with osteoarthritis of the knee if they live until age 85.
