Physical therapy for patients with knee and hip osteoarthritis: supervised, active treatment is current best practice
S.T. Skou1, E.M. Roos2
- Research Unit for Musculoskeletal Function and Physiotherapy, Dept. of Sports Science and Clinical Biomechanics, Univ. of Southern Denmark; Dept. of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hosp., Region Zealand, Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
2019 Vol.37, N°5 ,Suppl.120
PI 0112, PF 0117
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PMID: 31621559 [PubMed]
Accepted : 06/09/2019
In Press: 15/10/2019
Most patients with knee and hip osteoarthritis (OA) should be treated in primary care by non-surgical treatments. Building on substantial evidence from randomised trials, exercise therapy and education, typically delivered by physical therapists, are core first line treatments universally recommended in treatment guidelines for OA alongside weight loss, if needed. Exercise therapy provides at least as effective pain relief as pharmacological pain medications, without serious adverse effects; furthermore, the treatment effect from exercise therapy is similar, irrespective of baseline pain intensity and radiographic OA severity. Exercise therapy should be individualised to the preferences and needs of the individual patient, but at least 12 supervised sessions, 2 sessions per week, are required initially to obtain sufficient clinical benefit. Structured patient education concerning OA and its treatment options, including self-management, is important to retain motivation and adherence to an exercise programme and thereby maintain the effects over the long-term. If treatment effects from exercise therapy and patient education are insufficient, the physical therapist can deliver supplementary interventions that include knee orthoses and manual treatment.