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 .
Pilot study of the effects of a heat-retaining knee sleeve on joint pain, stiffness, and function in patients with knee osteoarthritis.
OBJECTIVE To identify changes in joint pain , stiffness , and functional ability in patients with knee osteoarthritis ( OA ) after use of a knee sleeve  that prevents loss of body heat by the joint . METHODS Subjects with symptomatic knee OA ( n = 52 ) were r and omized to 2 treatment groups : verum sleeve ( specially fabricated to retain body heat ) or placebo sleeve ( st and ard cotton/elastane sleeve ) . Subjects wore the sleeve over the more painful OA knee for at least 12 hours daily for 4 weeks . Pain , stiffness , and functional impairment ( Western Ontario and McMaster Universities Osteoarthritis Index [ WOMAC ] ) in the index knee were measured at baseline and after 4 weeks of wear , after which sleeve use was discontinued . Telephone followup interviews were conducted 2 and 4 weeks later . RESULTS After 4 weeks of sleeve wear , subjects in the active treatment group reported a 16 % decrease in mean WOMAC pain score relative to baseline ( P = 0.001 ) . Those who wore the placebo sleeve reported a 9.7 % decrease from baseline ( P = 0.002 ) . The difference between treatment groups was not statistically significant ( P = 0.12 ) . However , it was found that the 12 subjects who believed correctly that they had received the verum sleeve reported a highly significant decrease in WOMAC pain score ( -27.5 % relative to baseline , P = 0.0001 ) . In comparison , subjects who received the verum sleeve but believed they had received the placebo sleeve exhibited only a marginally significant improvement in pain ( -13.0 % relative to baseline , P = 0.07 ) . In the placebo group , the modest improvement in pain scores appeared unrelated to the subject 's impression of the type of sleeve worn . CONCLUSION This pilot study was insufficiently powered to be a definitive trial of the heat-retaining sleeve . Given the magnitude of changes in knee pain in the active treatment group , heat retention merits further scientific investigation as a treatment modality for patients with knee OA
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 .