Exercise for osteoarthritis of the knee

Abstract

There is platinum level evidence that land-based therapeutic exercise has at least short term benefit in terms of reduced knee pain and improved physical function for people with knee OA. The magnitude of the treatment effect would be considered small, but comparable to estimates reported for non-steroidal anti-inflammatory drugs.

Optimal primary care management of clinical osteoarthritis and joint pain in older people: a mixed-methods programme of systematic reviews, observational and qualitative studies, and randomised controlled trials

“…24 For example, most persons with OA were not receiving the full range of NICE core treatments for OA, 24 including advice and information regarded by NICE as a core requirement. 15 Patients with OA told us that they wanted help and support to self-manage their condition, 6,22,[25][26][27][28] because short-term changes in behaviour that benefit persons with OA, such as increased physical activity, are often not maintained in the long term, [29][30][31][32][33][34] and their comorbidities were often under-recognised in primary care and the community. [35][36][37][38][39] Our interpretation of the literature at that time highlighted an absence of evidence and information about key aspects of OA care in the community and primary care, including no clear estimate of the potential for prevention of OA in the population and health-care benefits among older people with joint pain and disability in the UK community.…”

“…33) indicates that 17% of the risk of severe pain 3 years later in the population of all people who start off with pain in at least one joint (adjusted for known confounders) is explained by having pain located specifically in the knee.…”

“…191 Clinical trials and systematic reviews consistently show the benefit of exercise, in a variety of forms, for this patient group. 33,122,[192][193][194] Exercise improves muscle dysfunction and reduces pain and disability without exacerbating joint damage. 195 It can reduce the risk of other chronic conditions 196 and improve the physical status of people with OA.…”

“…These reviews highlight a lack of information about how to optimise exercise for this patient group. 33,193,194 Most studies are short term, use limited measures of adherence and standardised exercise programmes. 205 Adherence, independent of exercise type, may be an important factor in the success of exercise interventions.…”

Multimodal physiotherapy may be no better than sham treatment for people with hip osteoarthritis

“…The need for individually tailored, supervised exercise programs of adequate dosage alongside education is still the current recommendation for people with hip osteoarthritis. 4,5 …”