Holden, MA, Button, K, Collins, NJ, Henrotin, Y, Hinman, RS, Larsen, JB, Metcalf, B, Master, H, Skou, ST, Thoma, LM, Wellsandt, E, White, DK and Bennell, K (2020) Guidance for implementing best practice therapeutic exercise for people with knee and hip osteoarthritis: what does the current evidence base tell us? Arthritis Care Res (Hoboken), 73 (12). pp. 1746-1753. ISSN 2151-464X

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Abstract

OBJECTIVE: Therapeutic exercise is a recommended first-line treatment for people with knee and hip osteoarthritis. However, there is little specific advice or practical resources to guide clinicians in its implementation. As the first in a series of projects by the Osteoarthritis Research Society International Rehabilitation Discussion Group to address this gap, we aim to synthesize current literature informing the implementation of therapeutic exercise for people with knee and hip osteoarthritis.

METHODS: Narrative review focusing on evidence from systematic reviews and randomized controlled trials.

RESULTS: Therapeutic exercise is safe for people with knee and hip osteoarthritis. Numerous types of therapeutic exercise (including aerobic, strengthening, neuromuscular, mind-body exercise) may be utilised at varying doses and in different settings to improve pain and function. Benefits from therapeutic exercise appear greater when dosage recommendations from general exercise guidelines for healthy adults are met. However, interim therapeutic exercise goals may also be useful, given that many barriers to achieving these dosages exist among this patient group. Theoretically-informed strategies to improve adherence to therapeutic exercise, such as patient education, goal setting, monitoring and feedback, may help maintain participation and optimise clinical benefits over the longer-term. Sedentary behaviour is also a risk factor for disability and lower quality of life in people with knee and hip osteoarthritis, although limited evidence exists regarding how best to reduce this behaviour.

CONCLUSION: Current evidence can be used to inform how to implement best practice therapeutic exercise, at a sufficient and appropriate dose, for people with knee and hip osteoarthritis.

Item Type: Article
Additional Information: The final version of this accepted manuscript can be found online with all the relevant information at; https://onlinelibrary.wiley.com/doi/abs/10.1002/acr.24434
Subjects: Q Science > Q Science (General)
R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine > RC925 Diseases of the musculoskeletal system
Divisions: Faculty of Medicine and Health Sciences > School of Primary, Community and Social Care
Related URLs:
Depositing User: Symplectic
Date Deposited: 18 Sep 2020 13:23
Last Modified: 11 Feb 2022 16:11
URI: https://eprints.keele.ac.uk/id/eprint/8666

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