Comparative analysis of piroxicam and post-isometric exercises in knee osteoarthritis in school teachers.

Abstract

Background: School teachers often have knee osteoarthritis due to the nature of their work.

Objective: To compare the effects of post-isometric exercise and piroxicam on pain and functional impairment in school teachers having knee osteoarthritis.

Method: A pragmatic, community-based, double-blinded, randomized clinical trial (IRCT20230202057310N4) was conducted was conducted at Muhammad Physical Therapy Clinic and Rehabilitation Center, Multan, Pakistan from September 2025 to July after approval from the Institutional Ethical Committee (). A total of 70 pre-diagnosed osteoarthritis patients were randomly assigned to two groups after enrollment using the lottery method. Patients of Group A were treated with post-isometric exercises for 12 weeks (3 sessions per week and each session lasted for 45 min), while those in Group B were given piroxicam (given orally 20 mg twice a day for 12 weeks). At baseline and the 18th session, pain and daily activities were measured using the Pain Catastrophizing Scale (PCS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale, and Numerical Pain Rating Scale (NPRS), biochemical (ESR, CRP, and WBCs) and radiological (X-rays) parameters were evaluated. The data was analyzed by using SPSS-23. The independent t-test compared differences between two unrelated groups while the paired t-test assessed differences within the same group. P-value <0.005 was considered significant.

Results: Out of 70 patients, 68 patients were assessed and there were 46 females and 21 males. The results showed a highly significant improvement in flexion (p = 0.001), WOMAC ADLs (p = 0.001), WOMAC stiffness (p = 0.004), PCS (p = 0.001) in group-A than group-B. Similarly, there was a highly significant improvement in NPRS (p = 0.001), WOMAC pain (p = 0.001), WBCs % (p = 0.002), ESR (p = 0.002) and CRP (p = 0.003) in group-B than group-A, underscoring the effectiveness of the post-isometric exercises.

Conclusion: These findings suggest that post-isometric exercises could be a more beneficial treatment option than piroxicam for knee osteoarthritis. The practical implications of this research are significant, as it demonstrates that post-isometric exercises not only enhance functional results but also reduce pain severity, offering a promising alternative to traditional medication.