Effectiveness of exercise in patients with osteoarthritis of hip of knee: nine months' follow up.

Objectives: To determine whether the effects of an exercise programme in patients with osteoarthritis of hip or knee are sustained at six and nine months' follow up. Methods: A randomized, single blind, clinical trial was conducted in a primary care setting. Patients with osteoarthritis of hip of knee (ACR criteria) were selected. Two intervention groups were comparized. Both groups received treatment from their general practitioner, including patient education and drug treatment if necessary. The experimental group also received exercise treatment from a physiotherapist in primary care. The treatment period was 12 weeks, with an ensuing 24 week follow up. The main outcome measures were pain, drug use (non-steriodal anti-inflammatory drugs), and observed disability. Results: 201 patients were randomly allocated to the exercise or control group, and 183 patients completed the trial. At 24 weeks exercise treatment it was associated with a small to moderate effect on pain during the past week (difference in change between the two groups -11.5 (95% CI -19.7 to -3.3). At 36 weeks no differences were found between the groups. Conclusions: Beneficial effects of excercise decline over time and finally disappear. (aut.ref.

Validiteit van het 'capsulair patroon' volgens Cyriax voor de diagnostiek van cox- en gonartrose

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Validity of Cyriax's concept capsular pattern for the diagnosis of osteoarthritis of hip and/or knee.

To analyse the validity of Cyriax's concept of the 'capsular pattern' in the diagnosis of osteoarthritis (OA) of hip and knee, data on 200 patients were analysed. The capsular pattern with limitations of medial rotation, flexion, and abduction, was not present in a distinct pattern in patients with OA of the hip. In patients with OA of the knee, an indication of the existence of a capsular pattern of the knee, with limited ranges of motion for both flexion and extension was found in subgroups of patients. It is concluded that the capsular pattern cannot be regarded as a valid test for the diagnosis of OA of the hip or knee. Further investigations in subgroups of patients are recommended. (aut.ref.