Wednesday, September 5, 2012

KNEE PAIN: GET HELP OR DO IT ON YOUR OWN?


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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