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Clinical Data: Hyalgan® with and without exercise

Quadricep Extension
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The Research Study

A study was conducted in order to determine whether or not the addition of regular exercise could improve upon the benefits of HYALGAN® injections for osteoarthritis knee pain.

The study involved 60 participants – all of whom were 50 years of age or older and had moderately severe knee osteoarthritis.  One third (ie. 20) of the patients received 5 weekly Hyalgan® injections, one-third of the patients received 3 weekly Hyalgan® injections and the final one-third received 3 weekly Hyalgan® injections and performed a home exercise program.  The home exercise program involved two exercises that were designed to strengthen the muscles in the front of the thigh known as the quadriceps muscles that attach to the knee.

The patients agreed to perform the exercises every other day after being shown a video of the exercises, shown a demonstration of the exercises, demonstrated the exercises themselves, and were given a handout that illustrated the exercises.

All of the patients kept a diary which recorded their level of pain and noted any pain medications that they were taking.  In order to help isolate the effects of the Hyalgan® injections +/- the exercises for those patients who were in the exercise group, the patients agreed not to make any medication changes or change any other aspects of their treatment from the osteoarthritis while they were enrolled in the twelve month study.

The patients came into the doctor’s office for periodic study visits at which time they would bring in their diary and were questioned and examined.  Although a few of the patients dropped out of the study, the majority completed the entire study.

— The patients who in fact underwent the exercise training in addition to the three Hyalgan® injections reported a faster onset of pain relief compared to those who only received the 3 injections or only received the 5 injections. —

Our approach is Integrative to achieve the most complete benefit

Benefit from the Integrative Approach

The Results of the Study:

Bell Creek & Right Flank Rd. is Integrative Regional Medical Center

All 3 of the treatment groups demonstrated an overall beneficial effect from treatment.

We Do Medical at IRMC

All 3 of the treatment groups overall, tolerated the injections +/- exercise very well.

Integrative Regional Medical Center at Bell Creek

The patients who received 5 Hyalgan® injections did better overall than the patients who received only 3 Hyalgan® injections.

We Do Physical Rehabilitation

The patients however, who performed exercises along with the 3 Hyalgan® injections did as well as the patients who received the 5 Hyalgan® injections.

Hyalgan® injections were safe and effective

The addition of exercises to Hyalgan® injections led to significant improvements in pain and if exercise is coupled with 3 Hyalgan® injections, the patients had pain relief that was equal to those who had 5 injections of Hyalgan®.

Physical Rehabilitation Room At IRMC

The patients who underwent the exercise training in addition to the three Hyalgan® injections reported a faster onset of pain relief compared to those who only received the 3 injections or only received the 5 injections.

A home exercise program of quadriceps strengthening can be safely combined with Hyalgan® injections.

For those patients who are willing to continue to exercise, a faster onset of pain relief may be seen compared to those who do not exercise.

Efficacy and Safety of Hyaluronan Treatment in Combination Therapy With Home Exercise for Knee Osteoarthritis Pain Todd P. Stitik, MD, Marcia F. Blacksin, MD, Doreen M. Stiskal, PT, PhD, Jong H. Kim, MD, PhD, Patrick M. Foye, MD, Lisa Schoenherr, BA, CCRC, Eun-Seok Choi, MD, PhD, Boqing Chen, MD, PhD, Howard J. Saunders, MA, CET, Scott F. Nadler, DO†
Arch Phys Med Rehabil Vol 88, February 2007 136-141