A randomized controlled trial on the efficacy of intermittent and continuous traction for patients with knee osteoarthritis

Objective: To investigate the efficacy of intermittent and continuous traction in the treatment of knee osteoarthritis. Design: A randomized, controlled, observer-blind seven-week trial. Setting: Hospital-based outpatient practice. Subjects: Ninety-eight patients with stage 3 knee osteoarthritis according to Kellgren-Lawrence radiological rating scale. Interventions: All 98 patients were randomly assigned to three treatment groups, for three weeks (weekends excluded). The control group (n=30, mean age: 59.30 +/- 8.16) received hot pack and short wave diathermy; the intermittent group (n=30, mean age: 58.20 +/- 7.78) received hot pack, short wave diathermy and intermittent traction; and the continuous group (n=30, mean age: 57.97 +/- 9.53) received hot pack, short wave diathermy and continuous traction. Outcome measurements: The values of the Turkish version of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale, and knee passive range of motion were measured at baseline, three-week and seven-week follow-up. Results: Compared with baseline at weeks 3 and 7, all the outcome measures, except range of motion, were significantly reduced in all groups (all P <= 0.001). In terms of the change data from baseline to week 3, both traction groups were significantly superior to the control in the WOMAC physical function scores. Considering the change data from baseline to week 7, both traction groups were significantly superior to the control in the pain scores, physical function and total scores, while only the continuous group was significantly better than the control in the stiffness scores (control: 1.17 +/- 1.64; continuous: 2.38 +/- 1.44) (P=0.014). Compared with baseline at weeks 3 and 7, range of motion values significantly increased in both traction groups (P < 0.05) but not in the control (P > 0.05). However, there were no significant differences among the three groups considering the change data from baseline to week 7 in range of motion values (P=0.300). Conclusions: Joint traction was found to be beneficial for the improvement of pain and physical function loss related to knee osteoarthritis.