KNEE PAIN: GET HELP OR DO IT ON YOUR OWN?
Recently one of my patients asked me why one has to come for
therapy instead of doing
exercises on their own and if there are studies done
on benefits of therapy versus home exercise program. So I did some research and
found several articles. One of them is called “Physical
Therapy Treatment Effectiveness for Osteoarthritis of the Knee: A Randomized
Comparison of Supervised Clinical Exercise and Manual Therapy Procedures Versus
a Home Exercise Program”
It was published in the vol. 85 of the Journal
of American Physical Therapy Association in December of 2005. The researches had assigned their
subjects into two groups one of which received supervised exercise,
individualized manual therapy, and a home exercise program over a 4-week
period. The other group received the same home
exercise program initially, reinforced at a clinic visit 2 weeks later. Here is the direct quote from the conclusion
of the research article:
“A
clinical physical therapy program of manual therapy to the lower quarter
combined with supervised exercise applied by skilled physical therapists was
compared with a home exercise program for improving function and decreasing
stiffness and pain in subjects with OA of the knee. The comprehensive clinical
treatment program resulted in large improvements, reproducing the results
previously reported for the same therapeutic regimen. After 1 month of treatment, the average improvement in pain, stiffness,
and function seen in the clinic treatment group was twice the magnitude
of the improvement observed in the home exercise group.
One
year after withdrawing the clinical intervention and further patient contact,
this difference between groups was no longer evident. Both groups remained
substantially improved over baseline measurements. Subjects in the clinic treatment group appeared less likely to be
taking medications for their arthritis and were more satisfied with the overall
outcome of their rehabilitative treatment at 1 year compared with subjects in
the home exercise group.”
I took the liberty of
highlighting couple of sentences above to stress the point and also to point
out another issue: recent developments in the administration of health care
show us that to save costs insurance companies will discourage their clients
from getting certain treatments. It’s true not just for physical therapy but
for other healthcare specialties. Patients are being forced to cut corners and
accept less treatment or possibly pay more out of pocket for their care. While it is certainly good for the patients
to accept responsibility for their well-being, self-treatment can lead to
longer recovery and to the necessity for more dramatic interventions, such as
surgery, in the future. In my
experience, timely intervention and properly done physical therapy can help you
feel better much faster and may prevent unnecessary complications in the
future.
What are your
thoughts on the subject? Please share your questions and concerns with me.
All the best,
Michael Sheynin,
P.T., Co-owner of Free Motion Rehabilitation Center.
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