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Clin Rehabil. 2017 May;31(5):596-611. doi: 10.1177/0269215517691084. Epub 2017 Feb 1.

The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part two: strengthening exercise programs.

Author information

1
1 Physiotherapy Program, University of Ottawa, Ottawa, Ontario, Canada.
2
2 Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
3
3 School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.
4
4 Faculty of Health Sciences, University of Sydney, Sydney, Australia.
5
5 School of Epidemiology, University of Ottawa, Ottawa, Ontario, Canada.
6
6 UNIFESP, Internal Medicine, Brasilia, Brazil.
7
7 Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Ontario, Canada.
8
8 Physical Therapy Teaching Supervisor, University of British Columbia, Vancouver, British Columbia, Canada.
9
9 Department of Physical Education and Sport, University of Granada, Granada, Spain.
10
10 School of Nursing, University of Ottawa, Ottawa, Ontario, Canada.
11
11 Canadian Forces Health Services Group Headquarters, National Defense, Ottawa, Ontario, Canada.
12
12 Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
13
13 School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
14
14 Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia.
15
15 Department of Rehabilitation, Reade Centre for Rehabilitation and Rheumatology, Amsterdam, Netherlands, Faculty of Health. ACHIEVE, Centre of Applied Research and School of Physiotherapy, University of Applied Sciences, Amsterdam, Netherlands.
16
16 Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia.
17
17 Department of Medicine, St. Joseph's Health Care Centre, Toronto, Ontario, Canada.
18
18 Faculty of Health Sciences, Clinical and Rehabilitation Sciences Research Group, University of Sydney, Sydney, Australia.
19
19 School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
20
20 The Arthritis Society, Ottawa Office, Ontario Division, Ottawa, Ontario, Canada.
21
21 Centre de recherche Epidémiologie et Biostatistique, Hôpital Hôtel-Dieu, Paris, France.
22
22 Institute of Rheumatology, Department of Medicine and Rehabilitation, Cochin Hospital, Paris, France.
23
23 Full Professor, Physiotherapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.

Abstract

OBJECTIVE:

To identify effective strengthening exercise programs and provide rehabilitation teams and patients with updated, high-quality recommendations concerning traditional land-based exercises for knee osteoarthritis.

METHODS:

A systematic search and adapted selection criteria included comparative controlled trials with strengthening exercise programs for patients with knee osteoarthritis. A panel of experts reached consensus on the recommendations using a Delphi survey. A hierarchical alphabetical grading system (A, B, C+, C, D, D+ or D-) was based on statistical significance ( p < 0.5) and clinical importance (⩾15% improvement).

RESULTS:

The 26 high-quality studies identified demonstrated that various strengthening exercise programs with/without other types of therapeutic exercises are generally effective for improving knee osteoarthritis management within a six-month period. Strengthening exercise programs demonstrated a significant improvement for pain relief (four Grade A, ten Grade B, two Grade C+), physical function (four Grade A, eight Grade B) and quality of life (three Grade B). Strengthening in combination with other types of exercises (coordination, balance, functional) showed a significant improvement in pain relief (three Grade A, 11 Grade B, eight Grade C+), physical function (two Grade A, four Grade B, three Grade C+) and quality of life (one Grade A, one Grade C+).

CONCLUSION:

There are a variety of choices for strengthening exercise programs with positive recommendations for healthcare professionals and knee osteoarthritis patients. There is a need to develop combined behavioral and muscle-strengthening strategies to improve long-term maintenance of regular strengthening exercise programs.

KEYWORDS:

Therapeutic exercise; clinical practice guideline; knee osteoarthritis; strengthening exercises; systematic review

PMID:
28183213
DOI:
10.1177/0269215517691084
[Indexed for MEDLINE]

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