Evidence Supports the Use of Therapeutic Ultrasound for Joint Osteoarthritis

A Cochrane systematic review (January 2010) and another recent clinical trial (May 2010) both provided support for therapeutic ultrasound (US) in the management of patients with osteoarthritis (OA).

The objective of the Cochrane systematic review was to compare therapeutic US with sham or no specific intervention in terms of effects on pain and function safety outcomes in patients with knee or hip OA. The authors concluded that, "In contrast to the previous version of this review, our results suggest that therapeutic ultrasound may be beneficial for patients with osteoarthritis of the knee."

The clinical study examined the short- and long-term efficacy in patients with primary hip OA with regard to pain, functional status, and quality of life (QoL). Forty-five patients with primary hip OA were enrolled into the study. The authors concluded that, "addition of therapeutic ultrasound to the traditional physical therapy showed a longitudinal positive effect on pain, functional status, and physical QoL in patients with hip osteoarthritis. The use of therapeutic ultrasound in the treatment of hip osteoarthritis should be encouraged."

References: Köybaşi M, Borman P, Kocaoğlu S, Ceceli E. The effect of additional therapeutic ultrasound in patients with primary hip osteoarthritis: a randomized placebo-controlled study. Clin Rheumatol. 2010 May 26.

Rutjes AW, Nüesch E, Sterchi R, Jüni P. Therapeutic ultrasound for osteoarthritis of the knee or hip. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD003132.

Dr. David P. Chen
Chiropractor in Laurel, MD
Laurel Regional Chiropractic

Knee Osteoarthritis

Moving to Maintain Function in Knee Osteoarthritis:

Evidence From the Osteoarthritis Initiative from Archives of Physical Medicine and Rehabilitation by Dorothy D. Dunlop, Pamela Semanik, Jing Song, Leena Sharma, Michael Nevitt, Rebecca Jackson, Jerry Mysiw, Rowland W. Chang, Osteoarthritis Initiative Investigators

Abstract: Dunlop DD, Semanik P, Song J, Sharma L, Nevitt M, Mysiw J, Chang RW, for the Osteoarthritis Initiative Investigators. Moving to maintain function in knee osteoarthritis: evidence from the Osteoarthritis Initiative.

Objectives: To investigate the association between baseline physical activity and 1-year functional performance in adults with knee osteoarthritis (OA).Design: Prospective cohort study of knee OA development and progression with 1-year follow-up.

Setting: Community.Participants: Osteoarthritis Initiative public data on adults with knee OA (n=2274; age, 45–79y) who participated in functional performance assessments (timed 20-m walk and chair stand test) at baseline and 1-year follow-up.Interventions: Not applicable.Main Outcome Measure: A good 1-year performance outcome (separately defined for walk time and chair stand measures) was improvement from baseline quintile or maintenance in the best quintile.

Results: Almost 2 in 5 persons with radiographic knee OA improved or maintained high performance at 1 year. Physical activity measured by the Physical Activity Scale for the Elderly (PASE) was significantly associated with good walk rate and chair stand outcomes (odds ratio per 40 units PASE [95% confidence interval]=1.13 [1.13, 1.17] and 1.10 [1.05, 1.15], respectively), as were participation in sports/recreational activities (1.45 [1.23, 1.71] and 1.29 [1.09, 1.51], respectively) and lifestyle activities (1.11 [1.06, 1.16] and 1.09 [1.04, 1.14], respectively). An independent protective relationship for these physical activity measures approached significance after adjusting for sociodemographic and health factors. Older adults reported the least baseline physical activity and least frequent good 1-year outcomes.

Conclusions: These findings support public health recommendations to be physically active in order to preserve function for persons with knee OA. Physical activity messages should specifically target older adults whose low activity levels may jeopardize their ability to maintain functional performance.


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