Patellar mobilization therapy — patellofemoral joint mobilization followed by supervised nonload vastus medialis oblique exercise — showed potential in reducing pain in patients with knee osteoarthritis, according to phase 2 findings recently published in Annals of Family Medicine.
“Presently, clinical guidelines recommend using nonpharmacological strategies as the first-line treatment for knee osteoarthritis and propose individualizing treatment based on the site of joint damage,” Regina Wing Shan Sit, MBBS, DCH, DPD, The School of Public Health and Primary Care at The Chinese University at Hong Kong, and colleagues wrote.
“Only a few clinical trials, however, have evaluated the role of manual therapy that targets patellofemoral joint osteoarthritis and they are limited by small sample size, lack of methodological rigor or heterogeneous interventions,” they added.
Researchers randomly assigned 208 patients with knee osteoarthritis in Hong Kong to either receive no therapy or three patella mobilization therapy treatment sessions from primary care physicians at 2-month intervals for 24 weeks and an accompanying prescription of a home-based vastus medialis oblique muscle exercise.
Sit and colleagues found there was greater improvement in the Western Ontario and McMaster Universities Osteoarthritis Index pain scores in the intervention group (between-group difference –15.6; 95% CI, –20.5 to –10.7) after 24 weeks. In addition, secondary outcomes — Western Ontario and McMaster Universities Osteoarthritis Index stiffness, function, and composite scores; objective physical function tests such as the 30-second chair stand, 40-meter walk test, timed up and go test, and EuroQol-5D; and visual analog scale score for pain — showed significant between-group differences.
Sit and colleagues provided other possible benefits to patellar mobilization therapy as they discussed the findings.
“Unlike conventional mobilization therapy, that involves multiple treatment sessions at intense frequency, our technique can easily be performed in primary care practices. The approximate time needed for primary care physicians to learn [patellar mobilization therapy] is about 1 hour, which includes an overview of the biomechanics of knee osteoarthritis and supervised practice on three to four patients,” they wrote.
“We observed a high patient compliance rate in our study, indicating that patellar mobilization therapy is an acceptable treatment option for our patients,” Sit and colleagues added. – by Janel Miller
Disclosures: The authors report no relevant financial disclosures.