Title: Knee Osteoarthritis: A Randomized Controlled Trial Comparing Hydrotherapy and Continuous Short-Wave Diathermy Category: 7. Osteoarthritis—clinical aspects Author(s): Tara Cusack1, Mary F. McAteer1, Leslie E. Daly1, Conor J. McCarthy2. 1University College Dublin, Dublin, Ireland; 2Mater Misericordiae University Hospital, Dublin, Ireland Presentation Number: 1335 Poster Board Number: 111 Purpose Osteoarthritis, a common disorder increasing in prevalence with advancing age, is particularly debilitating when the knees are affected. This study examined the influence of hydrotherapy or continuous short-wave diathermy (CSWD) on osteoarthritic symptoms, functional abilities and quality of life. Methods Sixty-seven patients aged between 50-70 years with a confirmed diagnosis of knee osteoarthritis, newly referred for physical therapy, were included. All patients received self-management education composed of advice and home exercises. Patients were randomized, in accordance with the factorial study design to one of four groups, combined hydrotherapy and CSWD (n=17), hydrotherapy only (n=17), CSWD only (n=18) and a control group (n=15) that received neither intervention. A visual analogue pain scale (VAS) (0-10cm), hand-held goniometry, the six-minute walk test and the arthritis impact measurement scales 2 (AIMS2) were completed at baseline and at eight weeks. Independent t-tests (SPSS 11) were used for between-group comparisons. Structured interviews, undertaken to assess patients’ perceptions of their treatment, were tape-recorded, transcribed and analyzed using a phenomenological approach. Results Sixty patients completed the programme, n=15 in each group. At eight weeks pain had decreased significantly (p<0.01) more in the hydrotherapy group than the no-hydrotherapy group. The distance walked over six minutes and the physical and symptomatic components of the AIMS2 improved to a greater degree in the hydrotherapy group, however these changes were not statistically significant (Table). CSWD did not change the measured outcomes significantly although the no-CSWD group reported a greater degree of pain relief and demonstrated a greater increase in distance walked over six minutes than the CSWD group (Table). Post-treatment interviews revealed that 77% (23/30) of hydrotherapy patients found hydrotherapy to be the most beneficial component of their programme, while 20% (6/30) of patients identified CSWD as being most beneficial. Patients reported that the self-management component assisted them in gaining knowledge and coping skills. Table: Mean changes in the hydrotherapy versus the no-hydrotherapy groups and the CSWD versus the no-CSWD groups from baseline to 8 weeks. Significance p<0.01* Hydrotherapy CSWD Yes No p= Yes No p= Pain (VAS) (cm) 1.67 0.12 0.006* 0.65 1.14 0.40 Six-minute walk test (m) 31.5 16.1 0.33 17.0 30.7 0.38 AIMS 2 Physical 0.31 0.11 0.22 0.23 0.18 0.73 Symptom 1.07 0.57 0.34 0.94 0.70 0.65
Conclusions This study does not support the inclusion of CSWD as part of a treatment programme for patients with knee osteoarthritis. Hydrotherapy however, as a component of a physical therapy programme, was effective in decreasing pain significantly.
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