Effectiveness of exercise with or without thermal therapy for community-dwelling elderly Japanese women with non-specific knee pain: A randomized controlled trial

Abstract

Knee pain is a common health problem in the elderly population, for which non-invasive treatments are recommended as a first line treatment in the management of knee pain. A randomized controlled trial was conducted to determine the effects of exercise with or without thermal therapy in community-dwelling elderly women with chronic knee pain. Women over 75 years of age with knee pain (n=150) were randomly assigned into four groups; exercise (Ex) and heat/steam generating sheet (HSGS) (n=38), Ex (n=37), HSGS (n=38), or health education (HE) (n=37). The Ex group attended a 60-min comprehensive training program twice a week for 3-months. The HSGS group placed two sheets on the knee for five hours per day. Functional fitness, visual analog scale (VAS), and Japanese knee osteoarthritis measure (JKOM) were assessed at baseline and post-intervention. The results showed VAS improvements in the Ex+HSGS and HSGS groups. Total JKOM score, muscle strength, and functional mobility significantly improved in the Ex+HSGS group compared with the HE group. The odds ratio (OR) for VAS and functional mobility improvement was more than eight times as great in the Ex+HSGS group (OR=8.60, 95% confidence interval (CI)=2.82–32.73) compared with the education group. Ex or HSGS alone were insufficient in enhancing functional fitness or improving pain and quality of life. The combined effects of both Ex and heat therapy seems to have an added benefit of decreasing pain, improving physical function and increasing quality of life. Trial Registration Number: JMA-IIA00110.