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

Brosseau, Lucie; Taki, Jade; Desjardins, Brigit; Thevenot, Odette; Fransen, Marlene; Wells, George A.; Imoto, Aline Mizusaki; Toupin‐April, Karine; Westby, Marie; Gallardo, Inmaculada C Álvarez; Gifford, Wendy; Laferrière, Lucie; Rahman, Prinon; Loew, Laurianne; Angelis, Gino De; Cavallo, Sabrina; Shallwani, Shirin M.; Aburub, Ala’ S; Bennell, Kim L; Esch, M. van der; Simić, Milena; McConnell, Sara; Harmer, Alison R.; Kenny, Glen P.; Paterson, Gail; Regnaux, Jean‐Philippe; Lefèvre-Colau, Marie-Martine; McLean, Linda

doi:10.1177/0269215517691084

Cited by 150 publications

(148 citation statements)

References 83 publications

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“…Exercise therapy for patients with knee OA consists of exercise for lower‐limb muscle strengthening, aerobic capacity, and training of daily activities like walking, stair climbing, and transfers (e.g. rising from a chair, getting into and out of a car) (Brosseau et al, 2017a,b; Fernandes et al, ; Fransen et al, ). Comorbidity may limit the exercise tolerance, depending on the type, number and severity of the comorbid disease(s) (de Rooij et al, ).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of an educational course for primary care physiotherapists on comorbidity‐adapted exercise therapy in knee osteoarthritis: an observational study

Rooij

Leeden

Esch

et al. 2020

Musculoskeletal Care

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Objective:The objectives of the present study were to: (1) evaluate the effect of an educational course on competence (knowledge and clinical reasoning) of primary care physical therapists (PTs) in treating patients with knee osteoarthritis (KOA) and comorbidity according to the developed strategy; and (2) identify facilitators and barriers for usage.Method: The present research was an observational study with a pretest-posttest design using mixed methods. PTs were offered a postgraduate course consisting of elearning and two workshops (blended education) on the application of a strategy for exercise prescription in patients with KOA and comorbidity. Competences were measured by questionnaire on knowledge (administered before and 2 weeks after the course), and a patient vignette to measure clinical reasoning (administered before the course and after a 6 month period of treating patients). Facilitators and barriers for using the strategy were assessed by a questionnaire and semi-structured interviews.Results: Thirty-four PTs were included. Competence (knowledge and clinical reasoning) improved significantly (p < 0.01). Fourteen out of 34 PTs had actually treated patients with KOA and comorbidity, during a 6-month period. The strategy was found to be feasible in daily practice. The main barriers included the limited number of (self-) referrals of patients, limited number of reimbursed treatment sessions by insurance companies and a suboptimal collaboration with (referring) physicians. Conclusion:A blended course on exercise therapy for patients with KOA and comorbidity seems to improve PTs' competence through increasing knowledge and clinical reasoning skills. Identified barriers should be solved before large-scale implementation of exercise therapy can take place in these complex patients. K E Y W O R D Sblended education, comorbidity, exercise therapy, knee osteoarthritis, primary care

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Section: Introductionmentioning

confidence: 99%

Evaluation of an educational course for primary care physiotherapists on comorbidity‐adapted exercise therapy in knee osteoarthritis: an observational study

Rooij

Leeden

Esch

et al. 2020

Musculoskeletal Care

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“…[40] The Ottawa Panel Clinical Practice Guidelines for the management of knee OA state that strength exercises cause a significant improvement in pain, function, and QoL parameters. [41] The effects of treatments which include general exercise are usually mid-to-long term. [37] Although there is no consensus on the exercise intensity and frequency parameters in knee OA patients, a recent systematic review reported that a total 24 exercise sessions in a 8-12 week period was very effective in knee OA patients, while a once-a-week exercise did not have any effect at all.…”

Section: Discussionmentioning

confidence: 99%

The effect of physical therapy and rehabilitation modalities on sleep quality in patients with primary knee osteoarthritis: A single-blind, prospective, randomized-controlled study

Altaş¹

2020

Turk J Phys Med Rehab

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Objectives: In this study, we aimed to evaluate the effect of physical therapy modalities on pain, sleep, mental status, and quality of life of patients with osteoarthritis (OA). Patients and methods: Between January 2017 and June 2017, a total of 40 patients (9 males, 31 females; mean age 56.6±8.9 years; range, 40 to 70 years) who were diagnosed with knee OA according to the American College of Rheumatology (ACR) criteria and were in Kellgren-Lawrence Grade 2-3 were included in the study. The patients were divided into two groups equally. Both groups received 15 sessions of exercise therapy, whereas the intervention group also received 10 consecutive physical therapy sessions in the form of hot pack, therapeutic ultrasound (US), and transcutaneous electrical nerve stimulation (TENS) by a single physiotherapist. Isometric and isotonic exercises were planned as 10 reps for three times a day as a home-based program. Clinical assessments were performed using the visual analog scale (VAS),

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“…In a meta-analysis of the literature, it was demonstrated that obesity is the risk factor with a major impact on knee osteoarthritis, joint pain and functional impotence (18). Given that obesity has the potential of being reduced, it is possible to propose a physical exercise program and a rigorous diet (19,20). The findings of a recent study on the influence of changes in patellar position in patellofemoral osteoarthritis, using magnetic resonance investigations, conclude that patella alta is a predictive factor for lateral patellofemoral osteoarthritis (21).…”

Section: Discussionmentioning

confidence: 99%

Evaluating risk factors involved in the alteration of biomechanics in relation to knee osteoarthritis

Tudorachi

Eva²,

Moscalu

et al. 2019

BALNEO

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The knee joint is very complex in terms of degrees of mobility and for normal biomechanics it is necessary for all the anatomical structures at this level to be within physiological limits. Problems can be caused by a number of risk factors such as age, sex, weight, or local risk factors such as patellar changes represented by patela alta or patella baja, which can lead to instability of the lower limb. Risk factors that may influence the development and progression of knee osteoarthritis have been evaluated. Changes in patellar position in relation to knee osteoarthritis were also studied. A group of 377 patients hospitalized for unilateral or bilateral knee pain with instability were included in the study. 239 of the 377 starting group presented knee osteoarthritis, constituting the study group. The risk factors analyzed were age, patient sex, BMI, weight status, anatomical changes in position of the patella (patella alta and patella baja), COBB angle and spine deviation. The results indicated that obesity, anatomical changes in the position of the patella, (patella alta), COBB angle and spine deviations represent significant risk factors in the onset of knee osteoarthritis.

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

Cited by 150 publications

References 83 publications

Evaluation of an educational course for primary care physiotherapists on comorbidity‐adapted exercise therapy in knee osteoarthritis: an observational study

Evaluation of an educational course for primary care physiotherapists on comorbidity‐adapted exercise therapy in knee osteoarthritis: an observational study

The effect of physical therapy and rehabilitation modalities on sleep quality in patients with primary knee osteoarthritis: A single-blind, prospective, randomized-controlled study

Evaluating risk factors involved in the alteration of biomechanics in relation to knee osteoarthritis

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