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- Title
The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part two: strengthening exercise programs.
- Authors
Brosseau, Lucie; Taki, Jade; Desjardins, Brigit; Thevenot, Odette; Fransen, Marlene; Wells, George A.; Imoto, Aline Mizusaki; Toupin-April, Karine; Westby, Marie; Álvarez Gallardo, Inmaculada C.; Gifford, Wendy; Laferrière, Lucie; Rahman, Prinon; Loew, Laurianne; De Angelis, Gino; Cavallo, Sabrina; Shallwani, Shirin Mehdi; Aburub, Ala’; Bennell, Kim L.; Van der Esch, Martin
- 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.
- Subjects
DELPHI method; EXERCISE; EXERCISE equipment; EXERCISE therapy; HEALTH surveys; HOME care services; KNEE diseases; LIFE skills; MEDICAL protocols; MUSCLE strength; OSTEOARTHRITIS; PAIN; PHYSICAL therapy; QUALITY of life; QUESTIONNAIRES; RESEARCH funding; SYSTEMATIC reviews; EVIDENCE-based medicine; RANDOMIZED controlled trials; VISUAL analog scale; RESISTANCE training
- Publication
Clinical Rehabilitation, 2017, Vol 31, Issue 5, p596
- ISSN
0269-2155
- Publication type
Article
- DOI
10.1177/0269215517691084