Manual Therapy (Postisometric Relaxation and Joint Mobilization) in Knee Pain and Function Experienced by Patients with Rheumatoid Arthritis: A Randomized Clinical Pilot Study.

Mateusz Wojciech Romanowski,Wojciech Romanowski,Anna Straburzyńska-Lupa,Maja Špiritović

doi:10.1155/2020/1452579

Abstract

Objectives The purpose of this study was to evaluate the impact of manual therapy on the management of rheumatoid arthritis (RA) patients with knee pain. Materials and Methods This was a small, randomized clinical pilot study. Subjects were 46 patients with diagnosed RA, randomly assigned to the manual therapy group (postisometric relaxation and joint mobilization) or control group (standard exercise). Subjects in each group had 10 sessions of interventions, once a day with one day break after the sixth day. Outcomes included the pain intensity of knee, Knee Society Score, Oxford Knee Score, and Health Assessment Questionnaire. Results There were no statistically significant differences between groups, except for the pain intensity of the knee. Conclusions This study suggests that manual therapy (postisometric relaxation and joint mobilization) may have clinical benefits for treating knee pain and function in rheumatoid patients. Further extended studies are expected to determine the effectiveness of manual therapy in RA patients with knee pain.

Highlights

Rheumatoid arthritis (RA) is an inflammatory, immunologically dependent, systemic connective tissue disease, leading to joint destruction and organ complications [1]. e knee is one of the most commonly affected joints in patients suffering from chronic RA [2].e estimated prevalence is 0.5–1%. e disease presents most commonly in women with a peak incidence at 55 years
Recent publications in the mainstream medical literature have reported the benefits of manual therapy, but there are only four studies evaluating its effects in RA patients [7,8,9,10]
We followed the randomization procedure of Romanowski et al [24]. It included eligible patients recruited from the patients who had been hospitalized in the rheumatology ward at this time with a diagnosis of RA [25], and they had pain in one knee (VAS) ≥ 4, disease activity score in 28 joints (DAS28) ≤ 5.1, and Power Doppler Ultrasonography (PDUS) ≤ grade 1 [26]

Summary

Introduction

Rheumatoid arthritis (RA) is an inflammatory, immunologically dependent, systemic connective tissue disease, leading to joint destruction and organ complications [1]. e knee is one of the most commonly affected joints in patients suffering from chronic RA [2]. E knee is one of the most commonly affected joints in patients suffering from chronic RA [2]. Pharmacologic treatment of RA patients commonly involves drugs such as nonsteroidal anti-inflammatories (NSAIDS), antitumor necrosis factors, disease-modifying antirheumatics, and/or corticosteroids [4]. Manual therapy refers to a group of methods used by physiotherapists, osteopaths, and chiropractors, with special training [12], to improve the range of motion [13] and function [14, 15] and decrease pain [16] at the knee joint. Studies have suggested that mobilization reduces pain and improves function, while increasing the range of motion [23]. Erefore, the objective of the present pilot randomized clinical trial was to assess the impact of manual therapy on pain and knee function in patients with RA

Materials and Methods

Manual erapy Group

Findings

Outcome Measures