Free Essay On Knee Osteoarthritis

Knee Osteoarthritis is a degenerative non-inflammatory affection of the knee joint, and is characterized by damage to the articular cartilage and by formation of new bones called osteophytes. Though both men and women are susceptible to osteoarthritis, the incidence is higher in post-menopausal women. This paper is an analysis of the beneficial effects of non-pharmacological interventions over pharmacological interventions, in treating knee osteoarthritis.
Exercises and physiotherapy are the nonpharmacological intervention applied in treating osteoarthritis. The National Institute of Health Research, University of York, conducted a systematic review and metaanalysis of case controlled studies, that were published across the world, to determine the beneficial effect of muscle strengthening exercise in reducing pain associated with osteoarthritis. The effectiveness of both the weight bearing and non-weight bearing exercises were compared. The control in this study were those affected with osteoarthritis, and not undergoing any exercise regimen. The age of the study subjects was 55 to 70 years. The duration of exercises was standardized to 3 times a week for 6 to 8 weeks. There was a clear indication of reduction in pain in the group that underwent muscle strengthening exercises. Both weight bearing and non-weight bearing exercises were equally beneficial in reducing pain associated with osteoarthritis to some extent. However, non-weight bearing exercises gave more positive outcome than weight bearing exercises. The outcome was measured using various widely accepted international standards in the field. The disadvantage with the studies that were published, was the wide variation in the symptoms, type of exercise and outcome. While in some individuals there was a signficant improvement in pain reduction, in others it was not statistically significant. Thus, it is very difficult to generalize the beneficial effect of exercise to every patient with osteoarthritis. (Tanaka, Ozawa, Kito & Moriyama, 2015)
In another review, the beneficial effect of exercise on all aspects of disease symptom like pain, quality of life, and disability was examined. Both post-operative and preoperative patient populations were included in this review, further enhancing the heterogeneity of the study population. At present, there is no cure for osteoarthritis, and non-pharmacological intervention will help reduce dependence on drugs. Though international guidelines have recommended exercise for reducing pain and improving quality of life, currently there is no one exercise regimen that fits all. As per research evidences, any land based exercises that are regularly done, under the monitoring of a health care professional will help to reduce drug dose, pain and improve physical activity. The Standard Mean difference (SMD) was between 0.30 to 0.50 for pain and 0.25 to 0.49 for physical function in the exercise group when compared to the group that did not receive exercise. The results were significant at 95% CI (Frasen, McConnell, Van der Esch, Simic & Bennell, 2015). The pain and swelling associated with osteoarthritis, discourages patients from using the joint, which in turn causes muscle atrophy, further limiting joint mobility and function. In order to prevent this, exercise can be made a regular part of the treatment regimen. Aquatic exercises produced small to moderate beneficial effect (SMD 0.26, 95% confidence interval) in alleviating pain when compared to the group that did not receive any exercise (Bartel, Lund, Dagfinrud, Christensen & Danneskiold, 2009) . Thus, non-pharmacological therapy in isolation or as an adjunct to pharmacological therapy is recommended for treating knee osteoarthritis.

References:

Bartel, E., Lund, H., Dagfinrud, H., Christensen, R., & Danneskiold, B. (2009). Aquatic exercise for the treatment of knee and hip osteoarthritis (Review). John Wiley & Sons.
Frasen, M., McConnell, S., Van der Esch, M., Simic, M., & Bennell, K. (2015). Exercise for osteoarthritis of the knee (Review). John Wiley & Sons.
Tanaka, R., Ozawa, J., Kito, N., & Moriyama, H. (2015). Efficacy of strengthening or aerobic exercise on pain relief in people with knee osteoarthritis: a systematic review and meta- analysis of randomized controlled trials. University of York.