| Methods |
Randomised
Controlled
Trial
Single‐blind
Single centre
Blinded physiatrists |
| Participants |
Country:
Taiwan
Mean age: 65.0
% Female: 80.7
Mean disease duration: range 5 mth to 12 y
Duration: 1 y
Number randomised: 140
(35 in each of 4groups)
Inclusion:
patients with bilateral moderate knee OA (Altman grade II)
Exclusion:
Not reported
Baseline values:
Range of motion
EX: 103
EX+US: 104
EX+US+HA: 103
CT: 101
Pain (10 cm VAS)
EX: 5.3
EX+US: 5.5
EX+US+HA: 5.6
CT: 5.4
Lequesne Index
EX: 7.6
EX+US: 7.4
EX+US+HA: 7.5
CT: 7.4
Ambulation speed (metres/minute)
EX: 72.6
EX+US: 71.3
EX+US+HA: 72.4
CT: 73.9
Mean peak torque at 60 degrees/second
EX: 230.4
EX+US: 232.7
EX+US+HA: 230.4
CT: 229.3
Mean peak torque at 180 degrees/second
EX: 181.5
EX+US: 183.3
EX+US+HA: 180.1
CT: 182.3 |
| Interventions |
1) EX: isokinetic muscular strengthening exercises,
2) EX+US: isokinetic exercise and pulse ultrasound treatment for painful periarticular soft tissue,
3) EX+US+HA: isokinetic exercise, pulse ultrasound treatment for painful periarticular soft tissue and intra‐
articular Hyalgan 20 mg/2ml 5 weekly injections,
4) CT: no treatment other than warmup exercises.
Patients received treatments 3 times weekly for 8 weeks. Patients in all groups received a warmup exercise with 20 minutes of hot packs and underwent passive range of motion exercises on an electric stationary bike (20 cycles per minute) for 5 minutes to both knees before undergoing muscle strengthening exercises.
Concurrent therapy: None reported. |
| Outcomes |
Active range of motion (standardised method for flexion, extension, excursion range),
Pain severity by 10 cm VAS (0=no pain, 10=maximum pain) after patient had remained in a weight‐bearing position (walking or standing) for 5 minutes,
Disability by the Lequesne Index (score: 1‐3 mild dysfunction, less than 7 functional status acceptable for isokinetic exercise, maximum score 26),
Ambulation speed ‐ 50 metres on treadmill at self‐selected pace ‐ walking time,
Muscle peak torque of knee flexion and extension with an isokinetic dynamometer |
| Notes |
Jadad's: 3/5
R‐2, B‐0, ‐1
Supported by a project grant from the National Science Counil of Taiwan. |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Allocation concealment (selection bias) |
Low risk |
A ‐ Adequate |
