Knee osteoarthritis: pneumatic compression tops cold therapy for swelling

  • Pain Res Manag

  • de Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • Intermittent pneumatic compression (IPC)+conventional physical therapy (PT) is superior to cold packs+conventional PT for knee swelling in patients with knee osteoarthritis (KOA).
  • The 2 procedures did not differ with respect to 7 other outcomes, including range of motion, muscle strength, and pain.

Why this matters

  • Swelling is the most frequent symptom of KOA.
  • Cold packs can cause skin burns and superficial nerve paralysis.
  • Findings suggest that IPC is a better way to control swelling.

Study design

  • Randomized controlled trial (n=81) of IPC+conventional PT (ultrasound, transcutaneous electrical nerve stimulation, electrical stimulation, and exercise) vs cold packs+conventional PT, each for 20 sessions over 4 weeks.
  • Knee swelling was measured by tape measure; knee flexion was measured by goniometer; muscle strength was measured by digital dynameter; and pain was measured by visual analog scale+Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).
  • Funding: Scientific Research Project Committee of University.

Key results

  • IPC group had greater reduction in knee swelling than the cold pack group (mean difference before vs after therapy±standard deviation was −2.60±0.86 vs −0.49±0.92 cm; P=.028).
  • No differences between groups in knee flexion, muscle strength, pain intensity, and WOMAC pain, stiffness, and physical function.

Limitations

  • Single-blind, single-center design.
  • Small sample sizes.