The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part three: aerobic 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:10.1177/0269215517691085

Cited by 81 publications

(76 citation statements)

References 42 publications

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“…Mind-body exercises are promising approaches to reduce pain and improve physical function in individuals with knee OA,70 although conflicting findings were reported for QoL 71. Similar to our findings, two reviews reported that yoga interventions have positive effects on QoL 70 71.…”

Section: Discussionsupporting

confidence: 65%

What interventions can improve quality of life or psychosocial factors of individuals with knee osteoarthritis? A systematic review with meta-analysis of primary outcomes from randomised controlled trials

et al. 2018

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Section: Discussionsupporting

confidence: 65%

What interventions can improve quality of life or psychosocial factors of individuals with knee osteoarthritis? A systematic review with meta-analysis of primary outcomes from randomised controlled trials

et al. 2018

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“…For example, the Yoga exercise [30] found in the rst iteration is in agreement with the current treatment guidelines that land-based exercise and mind-body exercise such as Tai Chi and Yoga are effective and safe for all patients with knee OA [35]. Similarly, the other suggested study by Krasilshchikov et al [31] found in the second iteration is also in harmony with the results of recent meta-analysis showing that aerobic exercise in combination with strengthening exercises are e cient in pain reduction and function improvement [36]. It should be noted that the studies by Cheung et al [30] and Krasilshchikov et al [31] had small sample sizes.…”

Section: Discussionsupporting

confidence: 77%

Interactive Multiobjective Optimization for Finding The Most Preferred Exercise Therapy in Knee Osteoarthritis

Shavazipour

Afşar

Multanen

et al. 2020

Preprint

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Background: The primary purpose of this study is to develop a decision support approach to support physicians or other healthcare professionals in comparing diﬀerent exercise therapies and identifying the most preferred one by balancing among cost, ability of improving physical function and reducing pain in patients with knee osteoarthritis.Methods: Thirty-one exercise therapies were selected from twenty-one randomized controlled trials from a previous meta-analysis. A multiobjective optimization model was designed to characterize the goodness of an exercise therapy based on ﬁve conﬂicting criteria: minimizing cost, maximizing pain reduction and disability improvement, minimizing the number of supervised exercise sessions and the length of the treatment period. Costs were estimated based on personal expenses regarding the information given in the collected randomized controlled trials. A novel interactive multiobjective optimization method was introduced to solve the model, where the physician’s preferences were taken into account in ﬁnding the most preferred exercise therapy. Results: An experienced physiotherapist was involved as a decision maker in the interactive solution process testing the proposed decision support approach. He iteratively provided preference information until he was satisﬁed with the set of therapies shown. After a more in-depth detailed analysis of selected therapies, the decision maker was able to ﬁnd the most preferred exercise therapy based on the patient's needs and health status. Conclusions: The proposed interactive multiobjective optimization method is promising in supporting the decision maker in balancing among conﬂicting criteria to ﬁnd the most preferred exercise therapy for patients with knee osteoarthritis. Moreover, the proposed method is generic enough to be applied in any field of medical and healthcare settings, where several alternative treatment options exist.

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

Abstract: A short-term aerobic exercise program with/without muscle strengthening exercises is promising for reducing pain, improving physical function and quality of life for individuals with knee osteoarthritis.

Cited by 81 publications

References 42 publications

What interventions can improve quality of life or psychosocial factors of individuals with knee osteoarthritis? A systematic review with meta-analysis of primary outcomes from randomised controlled trials

What interventions can improve quality of life or psychosocial factors of individuals with knee osteoarthritis? A systematic review with meta-analysis of primary outcomes from randomised controlled trials

Interactive Multiobjective Optimization for Finding The Most Preferred Exercise Therapy in Knee Osteoarthritis

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

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