Supplementing usual care with manual physiotherapy or an exercise programme results in substantial benefits for people suffering from knee or hip osteoarthritis (OA), New Zealand researchers have established. The University of Otago study also found that the additional treatment delivers benefits from a cost perspective.
The study involved four patient groups (207 people in total), one of them receiving only standard OA care and serving as the basis for comparison. Subjects in one of the other three groups received manual physiotherapy on top of usual care, with seven sessions lasting 40 to 50 minutes delivered over a period of nine weeks. Two additional sessions were provided seven weeks later. The second group had their usual care supplemented with an exercise programme and the third group received treatment combining manual and exercise therapy.
Haxby Abbott, associate professor at the Centre for Musculoskeletal Outcomes Research, said that manual physiotherapy and exercise programmes provided on top of usual OA care reduced pain and improved physical function for at least one year. However, the combination of manual and exercise therapy added to usual care was not found to deliver extra benefits. According to the lead researcher, this is due to the time constraints imposed by the length of a clinical visit.
In terms of cost effectiveness, exercise therapy delivered the best results where the healthcare system is concerned. From a societal perspective, however, manual therapy not only came on top but also proved cost-saving. It achieved the biggest symptom relief among the three treatments studied although exercise therapy also delivered great results. While neither can provide the same benefits for everyone, there is no doubt that each of them is better than restricting treatment to usual care, Abbott said.