The effectiveness of massage on pain, external knee adduction moment, and muscle Co-contraction in individuals with medial compartment knee osteoarthritis.

Abstract

Background: The pain, external knee adduction moment (EKAM), and muscle co-contraction are increased in knee osteoarthritis (KOA). Massage therapy decreases pain in KOA, yet KOA is a mechanical disease and biomechanical changes need to be investigated as well. Therefore, the current study aims to investigate the effectiveness of massage on these outcomes in individuals with medial KOA.

Methods: A cohort of fifteen participants with confirmed medial compartment KOA (2 males, 13 females, age: 61.33 (6.16) years; height: 1.62 (0.06) m; mass: 65.39 (4.04) kg; BMI: 24.74 (4.04) kg/m²) was given a six-week massage. Outcomes assessed pre- and post-intervention were: Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, temporal-spatial variables, knee joint kinematics and kinetics in sagittal, frontal, and transverse planes, vertical ground reaction force (GRF), and knee antagonist muscle co-contraction during gait. The paired t-test were used for statistical analysis.

Results: Fifteen participants completed the study. Significant improvements were observed in WOMAC scores (pain, stiffness, function, and total), walking speed, step length, 1st peak GRF, sagittal plane knee joint range of motion during stance, and medial muscle co-contraction in early and mid-stance (p < 0.05). However, no significant change was found in EKAM and knee adduction angular impulse (KAAI) (p > 0.05).

Conclusion: Massage therapy, as a stand-alone treatment, reduces pain, improves function, and decreases medial muscle co-contraction in individuals with medial KOA. Although EKAM did not change, the results suggest a reduction in medial muscle co-contraction might be a mechanism by which pain is improved.