Table 6.23Function

Function outcomeReferenceInterventionAssessment timeOutcome/effect size
Knee osteoarthritis
Manual therapy vs sham ultrasound
6-minute walk distance1 RCT (Deyle et al. 2000), N=83Manual therapy (movements, mobilisation and stretching) + exercise vs control (sham ultrasound)8 weeks (4 weeks post-treatment)170m difference, % CI 71 to 270 m, p<0.05
WOMAC score1 RCT (Deyle et al. 2000), N=83Manual therapy (movements, mobilisation and stretching) + exercise vs control (sham ultrasound)8 weeks (4 weeks post-treatment)599m difference, % CI 197 to 1002m, p<0.05
Restriction of activity, VAS (change from baseline)1 RCT (Bennell et al. 2005), N=140Manual therapy (knee taping, mobilisation, massage) + exercise vs control (sham ultrasound)12 weeks post-treatment−1.9 (manual) and −1.7 (control)
Manual better
WOMAC physical function (change from baseline)1 RCT (Bennell et al. 2005), N=140Manual therapy (knee taping, mobilisation, massage) + exercise vs control (sham ultrasound12 weeks post-treatment−7.5 (manual) and −6.7 (control)
Manual better
Step test, number of steps (change from baseline)1 RCT (Bennell et al. 2005), N=140Manual therapy (knee taping, mobilisation, massage) + exercise vs control (sham ultrasound)12 weeks post-treatment2.1 (manual) and 1.8 (control)
Manual better
Quadriceps strength, N/kg (change from baseline) at 12 weeks (end of treatment), 0.3 and 0.0 respectively and at, 0.3 and 0.1 respectively1 RCT (Bennell et al. 2005), N=140Manual therapy (knee taping, mobilisation, massage) + exercise vs control (sham ultrasound)12 weeks (end of treatment) and 12 weeks post-treatment12 weeks: 0.3 (manual) and 0.0 (control) 12 weeks post-treatment: 0.3 (manual) and 0.1 (control)
Manual better
Step test, number of steps (change from baseline)1 RCT (Bennell et al. 2005), N=140Manual therapy (knee taping, mobilisation, massage) + exercise vs control (sham ultrasound)12 weeks (end of treatment)1.5 (manual) and 1.4 (control)
Both groups similar
Restriction of activity, VAS (change from baseline1 RCT (Bennell et al. 2005), N=140Manual therapy (knee taping, mobilisation, massage) + exercise vs control (sham ultrasound)12 weeks (end of treatment)−1.6 (manual) and −1.9 (control)
Control better
WOMAC physical function (change from baseline)1 RCT (Bennell et al. 2005), N=140Manual therapy (knee taping, mobilisation, massage) + exercise vs control (sham ultrasound)12 weeks (end of treatment)−7.8 (manual) and −8.2 (control)
Control better
Manual therapy vs meloxicam
Flexion (degrees); Extension (degrees) and Patient-Specific Functional Scale, PSFS (1–11 scale).1 RCT (Tucker et al. 2003), (N=60)Manual therapy (motion palpation, thrust movement, manipulation) vs meloxicamMid-treatment and at 3 weeks (end of treatment)NS
Manual therapy vs manual contact
Sit-to-stand time1 RCT (Moss et al. 2007) (N=38)Manual therapy (large-amplitutde AP glide) vs control (manual contact)Immediate−5.06 (manual) and −0.35 (control), p<0.001
Favours manual
Total up-and-go time1 RCT (Moss et al. 2007) (N=38)Manual therapy (large-amplitutde AP glide) vs control (manual contact)ImmediateNS
Manual therapy vs no contact
Sit-to-stand time1 RCT (Moss et al. 2007) (N=38)Manual therapy (large-amplitutde AP glide) vs control (no contact)Immediate−5.06 (manual) and −7.92 (control), p<0.001
Favours manual
Total up-and-go time1 RCT (Moss et al. 2007) (N=38)Manual therapy (large-amplitutde AP glide) vs control (no contact)ImmediateNS
Manual therapy (pre-treatment vs post-treatment)
Functional squat ROM (degrees)1 cohort study (Cliborne et al. 2004), N=39Manual therapy (hip oscillatory mobilizations) – pre-treatment vs post-treatmentImmediatep<0.05
Favours manual
Hip flexion ROM (degrees)1 cohort study (Cliborne et al. 2004), N=39Manual therapy (hip oscillatory mobilizations) – pre-treatment vs post-treatmentImmediatep<0.01
Favours manual
FABER ROM (degrees), change from baseline1 cohort study (Cliborne et al. 2004), N=39Manual therapy (hip oscillatory mobilizations) – pre-treatment vs post-treatmentImmediate+3.6
Favours manual
Manual therapy vs usual care
WOMAC total, VAS (change from baseline)1 RCT (Perlman et al. 2006) (N=68)Swedish massage vs usual care8 weeks (end of treatment)−21.2mm (manual) and −4.6mm (control), p<0.001
Favours manual
WOMAC physical functional disability, VAS (change from baseline1 RCT (Perlman et al. 2006) (N=68)Swedish massage vs usual care8 weeks (end of treatment)−20.5 mm (manual) and −0.02 mm (control), p=0.002
Favours manual
ROM, degrees (change from baseline1 RCT (Perlman et al. 2006) (N=68)Swedish massage vs usual care8 weeks (end of treatment)7.2 (manual) and −1.1 mm (control)
Manual better
50-foot walk time, seconds (change from baseline1 RCT (Perlman et al. 2006) (N=68)Swedish massage vs usual care8 weeks (end of treatment)−1.8 (manual) and 0.2 (control)
Manual better
Hip
Manual therapy vs exercise
Walking speed (seconds)1 RCT (Hoeksma et al. 2004), N=109Manual therapy (manipulation + stretching) vs exercise5 weeks, end of studyEffect size 0.3, % CI −16.7 to −0.5, p<0.05
Favours manual
ROM flexion-extension (degrees)1 RCT (Hoeksma et al. 2004), N=109Manual therapy (manipulation + stretching) vs exercise5 weeks, end of studyEffect size 1.0,% CI 8.1 to 22.6, p<0.05
Favours manual
ROM external-internal rotation (degrees)1 RCT (Hoeksma et al. 2004), N=109Manual therapy (manipulation + stretching) vs exercise5 weeks, end of studyEffect size 0.9,% CI 6.1 to 17.3, p<0.05
Favours manual
ROM flexion-extension (degrees)1 RCT (Hoeksma et al. 2004), N=109Manual therapy (manipulation + stretching) vs exercise5 weeks, end of studyEffect size 1.0,% CI 8.1 to 22.6, p<0.05
Favours manual
Manual therapy (pre-treatment vs post-treatment)
Passive ROM (degrees)1 case-series (MacDonald et al. 2006), N=7Manual therapy (thrust movement, manipulation) pre-treatment vs post-treatment2 to 5 weeksMean change +23.3
Favours manual
Passive ROM internal rotation (degrees)1 case-series (MacDonald et al. 2006), N=7Manual therapy (thrust movement, manipulation) pre-treatment vs post-treatment2 to 5 weeksMean change +16.3
Favours manual
Total hip passive ROM (degrees)1 case-series (MacDonald et al. 2006), N=7Manual therapy (thrust movement, manipulation) pre-treatment vs post-treatment2 to 5 weeksMean change +84.3
Favours manual
Disability (Harris Hip Score)1 case-series (MacDonald et al. 2006), N=7Manual therapy (thrust movement, manipulation) pre-treatment vs post-treatment2 to 5 weeksMean change +20.0
Favours manual

From: 6, Non-pharmacological management of osteoarthritis

Cover of Osteoarthritis
Osteoarthritis: National Clinical Guideline for Care and Management in Adults.
NICE Clinical Guidelines, No. 59.
National Collaborating Centre for Chronic Conditions (UK).
Copyright © 2008, Royal College of Physicians of London.

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