Prolotherapy infused with dextrose helps in improving
performance and self reported measures in knee osteoarthritis patients.
The data
from a study by Rabago D et al. revealed that prolotherapy in a primary care
clinic is feasible and acceptable, as issued in 'The Journal of Alternative and
Complementary Medicine'. Limited nonsurgical treatment options are available
for knee osteoarthritis (KOA).
Prolotherapy
is an injection-based method for chronic KOA pain; the health plan coverage is
restricted, owing to an access barrier. Recently, a local health plan
considered the coverage for prolotherapy for KOA, but uptake and treatment
response in routine care are still undisclosed. The study authors performed a
pilot-level quality improvement (QI) project to determine the feasibility,
acceptability, and effects of prolotherapy for painful KOA in the primary care
setting.This QI prospective case series had invitation letters sent to the
symptomatic KOA patients with a primary care provider whose health plan had
prolotherapy. The primary care patients with KOA were given intra- and
extra-articular prolotherapy injections. A total of six prolotherapy sessions
was given to patients.
The
primary outcome measures comprised of feasibility having the response rate to
an invitation to utilise prolotherapy. The acceptability was determined in the
patient having adherence to, and satisfaction with, three or more prolotherapy
sessions. The secondary outcomes comprised of survey-based (the Western Ontario
McMaster University Osteoarthritis Index, WOMAC, 0-100; EuroQOL 5-D). The
treadmill gait analysis, function (30-sec chair stand, 4 × 10 m walk, 9-step
stair-climb), total activity (using accelerometer) and the preferred walking
speed were objectively examined.
The
outcome analysis (paired t-test) was according to the protocol, differentiating
the follow-up and baseline outcome data at ∼eight months.Total 39 patients were
invited out of which 11 responded and seven patients (with age 59.6 ± 9.3
years, six females) received 5.0 ± 1.1 prolotherapy sessions with a high
satisfaction rate. At 8.4 months, their WOMAC scores improved by 27.6 ± 19.5
points. In the 4 × 10 m walk, the functional testing improved by 8.0 ± 3.6 sec.
No group differences were observed between the baseline and follow-up in chair
stand, stair-climb, accelerometry, or gait outcomes. Five patients increased
their preferred walking speed." Self-reported improvement is similar to
that of the efficacy studies; office-based, objectively examined functional
assessment can be performed." Further evaluation is warranted, noted the
study authors.
The Journal of Alternative and Complementary Medicine
Dextrose Prolotherapy for Symptomatic Knee Osteoarthritis: Feasibility, Acceptability, and Patient-Oriented Outcomes in a Pilot-Level Quality Improvement Project
Rabago D et al.
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