Introduction: Osteoarthritis is a degenerative chronic disease of musculoskeletal system,
which is characterized by degeneration of the articular cartilage and a gradual onset of
pain, stiffness and limitation of movement. It most commonly affects the knee joint and is
usually found in females and the elderly. It is an incurable disease, therefore its treatment
is directed towards a reduction of symptoms and a decrease in the progression of the
condition. One of the possible choices for conservative treatment is manual therapy.
Purpose: The purpose of this diploma work is to present the efficiency of manual therapy
in treatment of knee osteoarthrosis based on a literature review. Methods: The search for
articles was conducted in data bases PubMed, Science Direct and PEDro, with key words
in English language: knee osteoarthrosis, treatment, physiotherapy, manual therapy,
passive joint mobilization, patella mobilization therapy, massage. From the data base
PEDro we summarized how the chosen studies were graded on the PEDro scale for
measurement of the quality of studies. Results: We included nine randomized controlled
studies. Techniques used in the studies were passive joint mobilization, soft tissue
mobilization, manual stretching, mobilization with movement, massage and a chiropractic
knee protocol. All techniques were efficient in reducing the pain on a visual analogue scale
and improving the Western Ontario and McMaster Universities osteoarthritis index.
Mobilization with movement and mobilization of the patellofemoral joint also improved
range of motion while massage therapy did not produce the same results. Passive joint
mobilization and mobilization with movement also improved the results of functional
testing. Discussion and conclusion: Manual therapy techniques proved to be an efficient
choice of treatment of knee osteoarthritis. The biggest impact was seen on reducing pain
and stiffness as well as improving range of motion, though manual therapy also showed
improvements in performance of functional tests. The reduced pain enabled patients to be
more active and consequently decelerated degenerative changes and muscle atrophy. It
would be reasonable to combine manual therapy with kinesiotherapy, especially in
combination with everyday home exercise. The effects of manual therapy will likely
diminish with time, though further studies of this area are needed.
|
