Several individual RCTs demonstrated clinical ly important improvements in pain and disability with aerobic exercise .
Other PT interventions demonstrated no sustained benefit .
Individual RCTs showed similar benefits with aerobic , aquatic , and strengthening exercise .
Adverse events were uncommon and did not deter participants from continuing treatment .
Low-strength evidence suggested that only a few PT interventions were effective .
BACKGROUND Osteoarthritis is a leading cause of disability .
Nonsurgical treatment is a key first step .
PURPOSE Systematic literature review of physical therapy ( PT ) interventions for community-dwelling adults with knee osteoarthritis .
A home-based protocol of electrical muscle stimulation for quadriceps muscle strength in older adults with osteoarthritis of the knee.
OBJECTIVE To determine whether home-based neuromuscular electrical stimulation ( NMES ) applied to the quadriceps femoris ( QF ) muscle increases strength , physical activity , and physical performance in older adults with knee osteoarthritis ( OA ) . METHODS Thirty-four adults ( > 60 yrs ) with radiographically confirmed symptomatic knee OA were r and omized to NMES plus education or education only ( EDU ) . The primary outcome was isometric QF peak torque ( PTIso ) , with secondary outcomes of daily step counts , total activity vector magnitude , 100-foot walk-turn-walk , timed stair climb , chair rise , and pain . The NMES group used a portable electrical muscle stimulator 3 days a week for unilateral QF training with incremental increases in the intensity of isometric contraction to 30 - 40 % of maximum over 12 weeks . Both groups received the 12-week Arthritis Self-Management course and were followed an additional 12 weeks . RESULTS The stimulated knee-extensor showed a 9.1 % increase in 120 degrees PTIso compared to a 7 % loss in the EDU group ( time x group interaction for 120 degrees PTIso ; p = 0.04 ) . The chair rise time decreased by 11 % in the NMES group , whereas the EDU group saw a 7 % reduction ( p = 0.01 , time ; p = 0.9 , group ) . Similarly , both groups improved their walk time by approximately 7 % ( p = 0.02 , time ; p = 0.61 group ) . Severity of pain reported following intervention did not differ between groups . CONCLUSION In older adults with knee OA , a home-based NMES protocol appears to be a promising therapy for increasing QF strength in adults with knee OA without exacerbating painful symptoms
Several individual RCTs demonstrated clinical ly important improvements in pain and disability with aerobic exercise .
Other PT interventions demonstrated no sustained benefit .
Individual RCTs showed similar benefits with aerobic , aquatic , and strengthening exercise .
Adverse events were uncommon and did not deter participants from continuing treatment .
Low-strength evidence suggested that only a few PT interventions were effective .
BACKGROUND Osteoarthritis is a leading cause of disability .
Nonsurgical treatment is a key first step .
PURPOSE Systematic literature review of physical therapy ( PT ) interventions for community-dwelling adults with knee osteoarthritis .