Lucie Brosseau1, Jade Taki2, Brigit Desjardins3, Odette Thevenot3, Marlene Fransen4, George A Wells5, Aline Mizusaki Imoto6, Karine Toupin-April7, Marie Westby8, Inmaculada C Álvarez Gallardo9, Wendy Gifford10, Lucie Laferrière11, Prinon Rahman12, Laurianne Loew13, Gino De Angelis13, Sabrina Cavallo13, Shirin Mehdi Shallwani13, Ala' Aburub13, Kim L Bennell14, Martin Van der Esch15, Milena Simic16, Sara McConnell17, Alison Harmer1, Glen P Kenny3, Gail Paterson18, Jean-Philippe Regnaux19, Marie-Martine Lefevre-Colau20, Linda McLean1. 1. 1 Physiotherapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada. 2. 2 Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada. 3. 3 School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada. 4. 4 Faculty of Health Sciences, University of Sydney, Sydney, Australia. 5. 5 School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada. 6. 6 UNIFESP, Internal Medicine, Brasilia, Brazil. 7. 7 Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, Faculty of Medicine and School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada. 8. 8 Mary Pack Arthritis Program, Vancouver Coastal Health, Department of Physical Therapy, University of British Columbia, Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada. 9. 9 Department of Physical Education and Sport, University of Granada, Granada, Spain. 10. 10 School of Nursing, University of Ottawa, Ottawa, Ontario, Canada. 11. 11 Canadian Forces Health Services Group Headquarters, National Defense, Ottawa, Ontario, Canada. 12. 12 Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada. 13. 13 School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada. 14. 14 Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia. 15. 15 Department of Rehabilitation, Reade Centre for Rehabilitation and Rheumatology, Amsterdam, Netherlands, Faculty of Health. ACHIEVE, Centre of Applied Research and School of Physiotherapy, University of Applied Sciences, Amsterdam, Netherlands. 16. 16 Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia. 17. 17 Department of Medicine, St. Joseph's Health Care Centre, Toronto, Ontario, Canada. 18. 18 The Arthritis Society, Ottawa Office, Ontario Division, Ottawa, Ontario, Canada. 19. 19 Centre de recherche Epidémiologie et Biostatistique, Hôpital Hôtel-Dieu, Paris, France. 20. 20 Institute of Rheumatology, Department of Medicine and Rehabilitation, Cochin Hospital, Paris, France.
Abstract
OBJECTIVES: To identify effective aerobic exercise programs and provide clinicians 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 used, based on statistical significance ( P < 0.5) and clinical importance (⩾15% improvement). RESULTS: The five high-quality studies included demonstrated that various aerobic training exercises are generally effective for improving knee osteoarthritis within a 12-week period. An aerobic exercise program demonstrated significant improvement for pain relief (Grade B), physical function (Grade B) and quality of life (Grade C+). Aerobic exercise in combination with strengthening exercises showed significant improvement for pain relief (3 Grade A) and physical function (2 Grade A, 2 Grade B). CONCLUSION: 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.
OBJECTIVES: To identify effective aerobic exercise programs and provide clinicians 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 used, based on statistical significance ( P < 0.5) and clinical importance (⩾15% improvement). RESULTS: The five high-quality studies included demonstrated that various aerobic training exercises are generally effective for improving knee osteoarthritis within a 12-week period. An aerobic exercise program demonstrated significant improvement for pain relief (Grade B), physical function (Grade B) and quality of life (Grade C+). Aerobic exercise in combination with strengthening exercises showed significant improvement for pain relief (3 Grade A) and physical function (2 Grade A, 2 Grade B). CONCLUSION: 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.