Supervised or unsupervised exercise for the treatment of hip and knee osteoarthritis. Clinical practice recommendations.

OBJECTIVES: To develop clinical practice guidelines concerning supervised or unsupervised kinesiotherapy for treating lower-limb osteoarthritis (OA).
METHOD: The SOFMER (French Physical Medicine and Rehabilitation Society) methodology, associating systematic literature review, collection of everyday clinical practice, and external review by a multidisciplinary expert panel, was used to develop guidelines. RESULTS-
CONCLUSION: Physical exercise is a part of the treatment of lower-limb OA. An educational pre-program is recommended to inform the patient about the ease and effectiveness of the physical exercise. Use of the SOFMER methodology led to recommending a program of initial physical exercise supervised by a physiotherapist, then an unsupervised program at home with compliance. The type, intensity, and frequency of the exercises must be adapted to each patient. Complementary randomized controlled studies are necessary to characterize the best exercises and their intensity and frequency. The OA location and gravity, functional need, and characteristics of patients will be useful in future studies.