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Tested and failed: taping, exercise, massage, mobilization for osteoarthritis

PainSci » bibliography » Bennell et al 2005
Tags: knee, physical therapy, arthritis, massage, exercise, taping, leg, limbs, pain problems, manual therapy, treatment, aging, self-treatment, controversy, debunkery, devices

One article on PainSci cites Bennell 2005: The Dubious Science of Kinesiology Tape

PainSci commentary on Bennell 2005: ?This page is one of thousands in the bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.

This paper reports on a test of several physical therapy techniques — taping, exercises, massage and mobilization — for knee osteoarthritis. I wouldn’t really expect any of those to be helpful for osteoarthritis, and they weren’t in this test. The researchers compared the treatment programme to a non-treatment of “sham ultrasound and light application of a non-therapeutic gel.” Everything produced pretty about the same results; the treatment programme was “no more effective than regular contact with a therapist.” This makes every component of the treatment programme look bad. If even one of them was moderately effective, patients should have gotten better. So this study constitutes decent evidence that taping, exercise, and massage are basically useless treatments for osteoarthritis of the knee, both individually and together, are not really going to put a dent in osteoarthritis.

~ Paul Ingraham

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

OBJECTIVE: To determine whether a multimodal physiotherapy programme including taping, exercises, and massage is effective for knee osteoarthritis, and if benefits can be maintained with self management.

METHODS: Randomised, double blind, placebo controlled trial; 140 community volunteers with knee osteoarthritis participated and 119 completed the trial. Physiotherapy and placebo interventions were applied by 10 physiotherapists in private practices for 12 weeks. Physiotherapy included exercise, massage, taping, and mobilisation, followed by 12 weeks of self management. Placebo was sham ultrasound and light application of a non-therapeutic gel, followed by no treatment. Primary outcomes were pain measured by visual analogue scale and patient global change. Secondary measures included WOMAC, knee pain scale, SF-36, assessment of quality of life index, quadriceps strength, and balance test.

RESULTS: Using an intention to treat analysis, physiotherapy and placebo groups showed similar pain reductions at 12 weeks: -2.2 cm (95% CI, -2.6 to -1.7) and -2.0 cm (-2.5 to -1.5), respectively. At 24 weeks, pain remained reduced from baseline in both groups: -2.1 (-2.6 to -1.6) and -1.6 (-2.2 to -1.0), respectively. Global improvement was reported by 70% of physiotherapy participants (51/73) at 12 weeks and by 59% (43/73) at 24 weeks. Similarly, global improvement was reported by 72% of placebo participants (48/67) at 12 weeks and by 49% (33/67) at 24 weeks (all p>0.05).

CONCLUSIONS: The physiotherapy programme tested in this trial was no more effective than regular contact with a therapist at reducing pain and disability.

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