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 .
Brace treatment for osteoarthritis of the knee: a prospective randomized multi-centre trial.
OBJECTIVE To evaluate the effect of a brace intended to reduce load in patients with medial or lateral compartmental osteoarthritis ( OA ) and concurrent varus or valgus alignment , respectively . DESIGN This multi-centre r and omized controlled trial ( performed 2001 - 2003 ) studies the additive effect of a brace intended to reduce load in conservative treatment of unicompartmental OA of the knee . SETTING Orthopedic department of a university medical centre and of one general hospital . The follow-up was 12 months . PATIENTS 117 patients with unicompartmental OA of the knee . Intervention group ( n=60 ) comprising conservative treatment with additional brace treatment and a control group ( n=57 ) comprising conservative treatment alone . PRIMARY OUTCOME MEASURES Pain severity and knee function score . SECONDARY OUTCOME MEASURES Walking distance and quality of life . ANALYSIS Multiple linear regression models according to the intention-to-treat-principle were used to assess outcome differences for the entire group of patients . In addition , we performed explorative subgroup analyses on primary overall outcomes stratified for alignment , degree of OA , origin of OA , and age . RESULTS Although the primary outcome measures were improved in the intervention group in comparison with the controls at each assessment point , the differences reached only borderline significance . The reported walking distances at 3 months , 12 months and overall were significantly longer in the brace group ( P=0.03 , P=0.04 and P=0.02 , respectively ) . Subgroup analysis showed a better effect in the varus group , in patients with severe OA , in patients with secondary OA and in patients younger then 60 years . In total 25 patients in the brace group and 14 in the control group changed their initial treatment , mostly ( 74 % ) because of a lack of beneficial effect . CONCLUSIONS The results indicate that a brace intended to reduce load shows small effects in patients with unicompartmental OA . However , many patients do not adhere in the long run to this kind of conservative treatment
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 .