Does cryotherapy associated with physical exercise add benefits to pain, function and quality of life in knee...

Exercise is the first-line treatment for knee osteoarthritis (KOA). Cryotherapy is used to control pain and inflammation, but robust evidence on its benefits is lacking.

Analyze the additional effects of cryotherapy, when associated with an exercise protocol, on pain, function, and quality of life in people with KOA.

A randomized controlled trial with sham and control groups, concealed allocation, blinded assessors, and intention-to-treat analysis. Individuals (n = 120) aged from 40 to 75, with knee pain ≥ 4 cm on 10 cm visual analog scale, and radiographic diagnosis of grade 2 or 3 (Kellgren and Lawrence) were included and divided into 3 groups (n = 40 per group): Exercise; Exercise + Cryotherapy; Exercise + Sham Cryotherapy Treatment was delivered 3 times per week for 8 weeks (24 sessions). Primary outcome was pain intensity (Visual Analog Scale). Secondary outcomes were physical function [Western Ontario and McMaster Universities (WOMAC)] and functional tests: 30-second sit-to-stand test, stair climbing test, 40-meter fast walking test, and quality of life [36-item Short Form Health Survey (SF-36)].

At post-intervention, for pain at rest, there were no between-group differences: Exercise vs. Exercise + Cryotherapy (mean difference, MD = -0.46 [confidence interval, 95% CI: -1.97, 1.05]), Exercise vs. Exercise + Sham (MD = -1.27 [95% CI: -2.78, 0.23]), Exercise + Cryotherapy vs. Exercise + Sham (MD = -0.82 [95% CI: -2.32, 0.69]). At follow-up period, the results also did not show between-group differences (p > 0.05).

Results showed the beneficial effects of exercise in the treatment of KOA, without additional effects of cryotherapy.