Effectiveness of manual therapy for improving pain and function in adults with hip or knee osteoarthritis: A sytematic review

Objective. To review the effectiveness of manual therapy in improving pain and function among adults with hip or knee osteoarthritis.Methods. Two reviewers performed a comprehensive search of electronic databases. Randomized clinical trials (RCTs) and case series were eligible if they included quantitative pain and physical function outcomes. Methodological quality was assessed using MacDermid's scale and Sackett's hierarchy of evidence.Results. 1 of 2 RCTs and 1 case series demonstrated positive effects on pain and/or function resulting from manual therapy for hip OA. 3 of 6 RCTs demonstrated positive effects resulting from manual therapy for knee OA. The methodological quality of all studies was moderate to high (MacDermid's score >25) and provided 1b, 2b, and 4 level evidence.Conclusion. A limited number of moderate to high quality studies suggest that manual therapy may be an effective intervention for decreasing pain and improving function for adults with hip and knee OA.