title: Efficacy of a comprehensive rehabilitation programme combined with pharmacological treatment in reducing pain in a group of OA patients on a waiting list for total joint replacement.
abstract: OBJECTIVE
  It has been shown that combined rehabilitation and pharmacological treatment reduce pain in subjects with osteoarthritis (OA), although the efficacy of either therapy alone may be limited. We studied the effects of a comprehensive rehabilitation programme alone and together with pharmacological treatment in relatively young OA patients awaiting total joint replacement (TJR).
  
  
  METHODS
  Forty-four OA patients randomly divided into two groups underwent three weeks of comprehensive day hospital rehabilitation treatment alone (group A) or in combination with acetaminophen 1g three times a day. Pain intensity was measured using a visual analogue scale (VAS) before and during treatment, and for four weeks afterwards, and compared between the groups using Student's t-test for unpaired data.
  
  
  RESULTS
  In group A, pain intensity was not reduced after the first week of treatment (T0 vs. T1: p=0.739), but was significantly reduced from the end of the second week to the end of the observation period (p<0.01). In group B, pain intensity was significantly reduced (p<0.01) from the first week of treatment to the end of the observation period. The differences in the VAS score variations from T0 between the two groups were statistically significant throughout the study period (T0-T1: p=0.004, T0-T2: p=0.041, T0-T3: p=0.035, T0-T4: p=0.009, T0-T5: p=0.011, T0-T6: p=0.014 T0-T7: p=0.015).
  
  
  CONCLUSIONS
  Rehabilitation is effective in reducing pain even in patients with severe OA on a waiting list for TJR, but its efficacy is boosted by adding appropriate pharmacological treatment.
authors.affiliation: Department of Clinical Neurophysiology & Pain Rehabilitation Unit, Rehabilitation Institute of Montescano, Salvatore Maugeri Foundation, IRCCS, Montescano (PV), Italy. roberto.casale@fsm.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Casale
authors.forename: Carlo
authors.initials: C
authors.lastname: Damiani
authors.forename: Vanessa
authors.initials: V
authors.lastname: Rosati
authors.forename: Fabiola
authors.initials: F
authors.lastname: Atzeni
authors.forename: Piercarlo
authors.initials: P
authors.lastname: Sarzi-Puttini
authors.forename: Adriana S
authors.initials: AS
authors.lastname: Nica
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage*; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage*; D018771:Arthralgia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D019643:Arthroplasty, Replacement; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists
chemical_list: D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen