Comparing the Effect of Continues and Intermittent Physiotherapy on the Pain and Function in Moderate Knee Osteoarthritis; A Pilot Randomized Clinical Trial Study

Osteoarthritis is the most common type of joint disorder. The present study compared the effects of continuous and intermittent physiotherapy on the pain and function of the individuals with moderate knee osteoarthritis. This randomized clinical trial study included 20 patients with moderate knee osteoarthritis randomly assigned into continuous and intermittent physiotherapy groups. The intervention was exactly the same for both groups including 10 sessions of conventional physical therapy. The treatment frequency was 6 and 3 sessions per week for continuous and intermittent groups, respectively. Using Knee injury and Osteoarthritis Outcome Score (KOOS) and Intermittent and Constant Osteoarthritis Pain (ICOAP) questioners, 6-minute-walking test, timed get up and go test, pain based on visual analogue scale (VAS), and function were assessed before, after 10 sessions, and after one month of follow up. The outcome was analyzed using independent t-test and, repeated measures ANOVA. Prior to the study, there was no significant difference between groups (P > 0.05). At the end of the 10th treatment session (P = 0.048), and after 1 month of follow up (P = 0.030), only the daily activity subscale of the KOOS questionnaire was significantly less in the continuous group. The records of 6-minute-walk test (P = 0.046), timed get up and go test (P = 0.040), continuous pain (P = 0.006), symptoms (P = 0.020), pain (P = 0.003), and quality of life (P = 0.010) subclasses of KOOS improved significantly in continuous group. After one month of follow up, daily activity subclass and pain based on VAS score were significantly better than baseline records (P = 0.002). In intermittent group, pain based on VAS score (P = 0.002) and continuous pain (P = 0.030) improved significantly after 10th session and follow up period). It seems that the frequency of the treatment sessions has no significant effect on the treatment results in short term. Thus, the physiotherapist may take the subject's preference and their time limitations for scheduling the sessions. Continuous intervention may probably be the better choice to reach better results while intermittent protocol may result in more lasting effects.