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ORIGINAL RESEARCH article

Front. Physiol.
Sec. Exercise Physiology
Volume 15 - 2024 | doi: 10.3389/fphys.2024.1451345

Effectiveness of Multimodal Active Physiotherapy for Chronic Knee Pain: A 12-Month Randomized Controlled Trial Follow-Up Study

Provisionally accepted
  • 1 China Institute of Sport Science, Beijing, China
  • 2 Beijing Sport University, Beijing, Beijing Municipality, China

The final, formatted version of the article will be published soon.

    This study aims to rigorously compare the effectiveness of APT versus conventional physical therapy (CPT) on pain and functional outcomes in patients with chronic knee pain. Eighty-seven patients with symptomatic and radiographically confirmed knee pain were included in this 12-month follow-up of a randomized controlled trial, conducted at a national institute and a rehabilitation clinic. Patients were randomized to either APT (n=44) or CPT (n=43). The APT protocol integrated pain neuroscience education, MWM, active myofascial release techniques, and structured exercises focusing on flexibility, stability, neuromuscular control, and coordination. The CPT protocol included health education, laser therapy, ultrasound therapy, and exercise. Both interventions were performed for 60 minutes twice a week for 3 months. The primary outcome was the Knee Injury and Osteoarthritis Outcome Score-4 domain version (KOOS4). Secondary outcomes included pain intensity (VAS), KOOS-pain, activities of daily living (ADL), function in sport and recreation (Sports/Rec), knee-related quality of life, global rating of change (GROC), quality of life (SF-36), Tampa Scale for Kinesiophobia (TSK), and functional performances measured at different intervals. Intention-to-treat analyses were performed. Of the 87 patients, 70 (80.5%) completed the 12-month follow-up. KOOS4 improved more in the APT group (16.13; 95% CI, 10.39 to 21.88) than in the CPT group (11.23; 95% CI, 5.42 to 17.04). APT showed additional improvement in KOOS4 compared to CPT (2.94; 95% CI: 0.04 to 5.85, p = 0.047). The VAS difference was -3.41mm (95% CI: -6.40 to -0.43, p=0.025), favoring APT. APT also showed more improvements in KOOS-pain, KOOS-ADL, KOOS-Sports/Rec, and TSK (p < 0.05). No differences between groups were observed in GROC and SF-36. APT significantly improved most functional performance variables compared to CPT (p < 0.05). Active Physiotherapy outshines conventional physical therapy by delivering more substantial reductions in pain intensity and marked enhancements in function among patients with knee pain. This distinctive efficacy underscores the invaluable role of APT in the management of chronic knee pain. By actively involving patients in their recovery journey, APT not only fosters superior results but also emphasizes the critical need to integrate these advanced therapeutic strategies into everyday clinical practices.

    Keywords: multimodal physiotherapy, active physiotherapy, Knee Pain, functional recovery, Functional training

    Received: 19 Jun 2024; Accepted: 06 Nov 2024.

    Copyright: © 2024 Cui, Zhao, Guo, Wang, Han, Zhang, Zhou and Yan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Peng Zhao, China Institute of Sport Science, Beijing, China
    Xiaoya Zhang, Beijing Sport University, Beijing, 100084, Beijing Municipality, China
    Qi Yan, China Institute of Sport Science, Beijing, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.