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Cited by 72Lower Extremity Biomechanics and PathologiesOsteoarthritis Treatment and MechanismsMusculoskeletal pain and rehabilitation

Exercise, education, manual-therapy and taping compared to education for patellofemoral osteoarthritis: a blinded, randomised clinical trial

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Crossley, K.M., Vicenzino, B., Lentzos, J., Schache, A.G., Pandy, M.G., Ozturk, H., Hinman, R.S.·2015·Osteoarthritis and Cartilage
DOI 10.1016/j.joca.2015.04.024
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Abstract

Objective Patellofemoral joint osteoarthritis (PFJ OA) contributes considerably to knee OA symptoms. This study aimed to determine the efficacy of a PFJ-targeted exercise, education manual-therapy and taping program compared to OA education alone, in participants with PFJ OA. Methods A randomised, participant-blinded and assessor-blinded clinical trial was conducted in primary-care physiotherapy. 92 people aged ≥40 years with symptomatic and radiographic PFJ OA participated. Physiotherapists delivered the PFJ-targeted exercise, education, manual-therapy and taping program, or the OA-education (control condition) in eight sessions over 12 weeks. Primary outcomes at 3-month (primary) and 9-month follow-up: (1) patient-perceived global rating of change (2) pain visual analogue scale (VAS) (100 mm); and (3) activities of daily living (ADL) subscale of the Knee injury and Osteoarthritis Outcome Score (KOOS). Results 81 people (88%) completed the 3-month follow-up and data analysed on an intention-to-treat basis. Between-group baseline similarity for participant characteristics was observed. The exercise, education, manual-therapy and taping program resulted in more people reporting much improvement (20/44) than the OA-education group (5/48) (number needed to treat 3 (95% confidence interval (CI) 2 to 5)) and greater pain reduction (mean difference: -15.2 mm, 95% CI -27.0 to -3.4). No significant effects on ADL were observed (5.8; 95% CI -0.6 to 12.1). At 9 months there were no significant effects for self-report of improvement, pain (-10.5 mm, 95% CI -22.7 to 1.8) or ADL (3.0, 95% CI -3.7 to 9.7). Conclusion Exercise, education, manual-therapy and taping can be recommended to improve short-term patient rating of change and pain severity. However over 9-months, both options were equivalent. Trial registration Australian New Zealand Clinical Trials Registry (ACTRN12608000288325): https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=82878.

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  • There is currently no standardized treatment approach for temporomandibular joint dysfunction, and clinicians tend to use a multimodal approach including education, exercise, and manual therapy.

    “There is currently no standardized treatment approach for TMJ dysfunction, and clinicians tend to use a multimodal approach50, 51, 52 to care including education, exercise, and MT.”

    From The Effect of Upper Cervical Mobilization/Manipulation on Temporomandibular Joint Pain, Maximal Mouth Opening, and Pressure Pain Thresholds: A Systematic Review and Meta-Analysis (2023) · cites this paper as [51]

    The Randomisation and interventions section describes a multimodal programme combining education, exercise, and manual therapy. But the trial concerns patellofemoral osteoarthritis, not temporomandibular joint dysfunction; it does not establish that TMJ treatment lacks a standardized approach or that clinicians generally use this combination for TMJ care. (LLM, conf=0.82)

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Authors
Crossley, K. M., Vicenzino, B., Lentzos, J., Schache, A. G., Pandy, M. G., Ozturk, H., & Hinman, R. S.
Affiliations
  • The University of Queensland (AU)
  • The University of Melbourne (AU)
Corresponding author
Crossley, K.M.
ORCID
Venue
Osteoarthritis and Cartilage
Publisher
Elsevier BV
Published
2015-09
Volume
23
Issue
9
Pages
1457-1464
ISSN
1063-4584 (ISSN-L)
DOI
10.1016/j.joca.2015.04.024
OpenAlex
W1899530158
Cited by
72
References
0
Citations by year
2026: 1 · 2025: 3 · 2024: 8 · 2023: 5 · 2022: 4 · 2021: 5 · 2020: 10 · 2019: 8 · 2018: 9 · 2017: 10 · 2016: 7 · 2015: 2
FWCI
4.64
Type
journal article
Language
en
Open access
Licence
Locations
  • Osteoarthritis and Cartilage (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Health and Medical Research Council (#508966)
  • Australian Research Council (FT#130100175)
Topics
  • Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
  • Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Keywords
patellofemoral osteoarthritis, knee osteoarthritis, exercise therapy, patient education, manual therapy, kinesio taping, physiotherapy intervention, analgesia, activities of daily living, primary care physiotherapy, number needed to treat, long-term outcomes, patient-reported outcomes, KOOS, knee function, knee stiffness
MeSH terms
Activities of Daily Living, Adult, Exercise Therapy, Female, Humans, Male, Middle Aged, Pain Measurement, Patient Education as Topic, Osteoarthritis, Knee, Musculoskeletal Manipulations, Athletic Tape, Patient Outcome Assessment

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