【論文摘要】The Effects of Manual Therapy in Addition to Exercise Therapy for Patients With Knee Osteoarthritis: A Systematic Review and Meta-Analysis

【論文摘要】退化性膝關節炎運動治療合併徒手治療之額外效果：系統性文獻回顧與統合分析

戴菀葶(Wan-Ting Tai) ； 林倩如(Chien-Ju Lin) ； 黃昱豪(Yu-Hao Huang) ； 李雪楨(Hsuei-Chen Lee) ； 陳文英(Wen-Yin Chen)

《物理治療》 44卷2期 (2019/06) Pp. 88-89

https://doi.org/10.6215/FJPT.201906.O06

摘要

Background and Purpose: Exercise therapy is the first-line management for patients with knee osteoarthritis (KOA). Recently published systematic reviews and clinical practice guidelines suggested that exercise therapy should be combined with manual therapy for improving intervention efficacy in cases of pain. However, no consensus has been reached due to lacking up-to-date evidence support in the literature. Therefore, the purpose of this systematic review and meta-analysis was to investigate the effects of manual therapy in addition to exercise therapy for patients with KOA. Methods: We searched related databases and identified studies on knee osteoarthritis before May 2016, in comparing exercise plus manual therapy to exercise therapy alone on functional enhancement and pain reduction. Results: A total of 9 studies were included. The analysis showed that exercise plus manual therapy resulted in superior functional improvement both in the short-term (pooled effect size = -0.51) and long-term (pooled effect size = -0.29) as compared to exercise alone. Also, the analysis favored the combination of exercise and manual therapy in the long-term pain reduction effect (pooled effect size = -0.52). Conclusion: When compared to only exercise therapy, exercise plus manual therapy showed significantly better improvement in functional performance and pain reduction, especially in the long-term effect. Clinical Relevance: For patients with KOA, additional manual therapy provided better outcome than exercise therapy alone; especially in functional improvement and pain reduction.