Therapy Found to Aid Arthritic Knees

A study using physical therapy on elderly patients with osteoarthritis in the knees found that most had increased functional capacity and less pain, researchers said.

Pain is the primary complaint of people with osteoarthritis of the knees, said one of the principal investigators, Dr. Glen E. Gresham, chair of the rehabilitation medicine department at the State University of New York at Buffalo.

Gresham and colleagues conducted their study on 80 older people with osteoarthritis of the knees--a condition that affects about 10% of the elderly population. Of the 80 patients, 72 experienced less pain, 68 had improved muscle strength and endurance, and 76 had increased capacity.

The pain, stiffness, decreased range of motion and muscle weakness that accompany the condition can severely impair the ability to climb stairs, rise from a chair, stand comfortably and walk.

“When I started I could go up, but not down stairs--I had to go down on my fanny--because of the pain and weakness in my right leg,” said patient Steve Rubach, 65, of Snyder. “Now I can go up and down the stairs like crazy.”

The three-month rehabilitation program, which strengthens the leg muscles around the knee using a specially developed exercise bench, tries to delay the progression of the condition and postpone artificial knee surgery.

“We’re not claiming that you would completely do away with the need for a knee replacement eventually, but it’s quite conceivable now that it would postpone the day,” said Gresham, who suffers from the condition himself.

“I think most of us that are facing a replacement eventually, and I include myself in that group, we’re not at all eager to rush into it,” he said.

“It’s a study that convinces us all we’re doing the right thing” by exploring physical therapy as an alternative treatment, Dr. Frederic McDuffie, director of the Arthritis Center at Piedmont Hospital in Atlanta.

“The study would have been a little better if they got some other type of therapy or no treatment to show the difference” among therapies, he said.

The Buffalo researchers said that what makes their program special is that it measures patient progress in a quantifiable way, measuring muscle strength and endurance and the speed of muscle contraction.

Physical therapy and quantitative progressive exercise, both used in the study, previously were not considered an option for patients with osteoarthritis in the knees because of a lack of evidence that they would help, he said.

“I think we will see in the future that based on these studies . . . the role of physical therapy in improving the quality of life with arthritis will be increasingly appreciated,” Gresham said at a recent news conference.

Two preliminary studies were published in the Archives of Physical Medicine and Rehabilitation; the university said the latest study has not been published yet.

“What many people in this project have experienced is that if you get a little stronger, you can go back to some exercise activities like walking,” Gresham said. “That helps your mobility and, in turn, decreases pain.”

Rubach and several other patients agreed.

Stanley Liszka, 70, of Buffalo used to walk 3 miles a day, but the condition limited his walking to two or three blocks.

“With the physiotherapy, I’ve felt a lot better,” he said. “It’s improved my walking and it’s improved my pain. I felt like a human being.”