Pt beats steroid injections for knee oa global academy for private neuro physiotherapy medical education

“considering the very low utilization rate of physical therapy prior private neuro physiotherapy to arthroplasty, perhaps we should more often give it a try before private neuro physiotherapy declaring that conservative care has failed and moving on to private neuro physiotherapy surgical management,” concluded dr. Rhon, director of the primary care musculoskeletal research center at brooke private neuro physiotherapy army medical center in san antonio.

Various studies have shown that close to 50% of patients with knee OA receive one or more intra-articular corticosteroid injections within 5 years prior to undergoing total private neuro physiotherapy knee arthroplasty, compared with physical therapy in only about 10% of patients, even though most guidelines rate both as first-line therapies, he noted at the meeting sponsored by the osteoarthritis research private neuro physiotherapy society international.

He presented a randomized trial of 156 patients who sought private neuro physiotherapy treatment for pain caused by knee OA at army medical private neuro physiotherapy center primary care clinics. To his knowledge, this was the first-ever randomized, head-to-head comparison of the effectiveness of a physical therapy regimen private neuro physiotherapy versus corticosteroid injections for knee OA. Because he and his coinvestigators wanted a pragmatic study giving private neuro physiotherapy each treatment strategy its due, booster therapy was available to patients who requested it. Patients in the corticosteroid arm were able to receive up private neuro physiotherapy to two additional spaced intra-articular injections as needed, while those assigned to the individualized manual physical therapy intervention, which utilized exercises targeting the typical strength and movement deficits private neuro physiotherapy found in patients with knee OA, could have up to three additional sessions. At the outset, all participants received education about the benefits of regular low-impact physical activity, weight reduction, and strength and flexibility exercises.

The two treatment groups were comparable except that the physical private neuro physiotherapy therapy group had a longer disease duration – a mean of 123 months as compared with 89 in private neuro physiotherapy the corticosteroid group – and more radiographically severe disease. Indeed, 60% of patients randomized to physical therapy were kellgren-lawrence scale grade III-IV, versus 45% of those assigned to intra-articular corticosteroid injection.

The primary outcome in the study was change in western private neuro physiotherapy ontario mcmaster universities arthritis index (WOMAC) score at 12 months. As early as 4 weeks into the study, the physical therapy group showed significantly greater improvement than in private neuro physiotherapy the comparison arm: from a mean baseline WOMAC score of 115 to 42.9 at 4 weeks, 42.5 at 6 months, and 38.4 at 1 year. The comparable figures in the intra-articular corticosteroid group were 113.3 at baseline, 53.3 at 4 weeks, 57.9 at 6 months, and 53.8 at 1 year.

The median improvement in WOMAC score at 1 year was private neuro physiotherapy 52% in the corticosteroid group and 71% in the physical therapy arm. About 59% of the physical therapy group experienced at least a 50% reduction in WOMAC score at 12 months, as did 38% of intra-articular injection recipients. The number needed to treat with physical therapy instead of private neuro physiotherapy intra-articular corticosteroids in order for one additional patient to achieve private neuro physiotherapy at least a 50% improvement in WOMAC score through 1 year of follow-up was four.

In terms of downstream utilization of health care, there were two knee arthroplasties and one arthroscopy in the private neuro physiotherapy study population, all in the intra-articular corticosteroid group. Seven patients in the intra-articular steroid group received more than three injections, including one patient with nine. And 13 patients in the physical therapy arm went outside private neuro physiotherapy the study in order to receive at least one corticosteroid private neuro physiotherapy injection.

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