Benefit form manual physiotherapy and exercise in knee osteoarthritis
Most patients with knee osteoartritis will benefit from a low-risk, cost-effective program of manual physical therapy and supporting exercise. This clinical prediction rule identifies those patients who may not benefit from such a program. After validation, this rule could improve primary patient management, allowing more appropriate referrals and choices in intervention.
Research authors: Deyle GD, Gill NW, Allison SC, Hando BR, Rochino DA
Version: 1.10
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  • Orthopaedics
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How this model should be used: 
For most patients with knee osteoarthritis (OA), the combined intervention of manual physical herapy and exercise is clinically beneficial, relatively inexpensive, and has no known adverse effects.1 This model defines the population of patients with knee OA who are unlikely to benefit from manual physical therapy and exercise, requiring alternative interventions.

Definition of nonsuccess: 
Nonsuccess was defined as improvement of <12% in the total Western ontario macmaster (WOMAC) score after 4 weeks of treatment.2

Model performance: 
The final regression model was a good fit to the data: Hosmer & Lemeshow test X2 = 2.90 (P=.940); Nagelkerke R2=0.680.

Sources: 
1 Ludica CA. Can a program of manual physical therapy and su- pervised exercise improve the symptoms of osteoarthritis of the knee? J Fam Pract. 2000;49:466-467.
2 Deyle GD, Gill NW, Allison SC, et al. Knee OA: which patients are unlikely to benefit from manual PT and exercise? J Fam Pract. 2012;61(1):E1-8.

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This model is provided for educational, training and information purposes. It must not be used to support medical decision making, or to provide medical or diagnostic services. Read our full disclaimer.

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