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 .
The treatment of osteoarthritis of the knee with pulsed electrical stimulation.
OBJECTIVE The safety and effectiveness of pulsed electrical stimulation was evaluated for the treatment of osteoarthritis ( OA ) of the knee . METHODS A multicenter , double blind , r and omized , placebo controlled trial that enrolled 78 patients with OA of the knee incorporated 3 primary efficacy variables of patients ' pain , patients ' function , and physician global evaluation of patients ' condition , and 6 secondary variables that included duration of morning stiffness , range of motion , knee tenderness , joint swelling , joint circumference , and walking time . Measurements were recorded at baseline and during the 4 week treatment period . RESULTS Patients treated with the active devices showed significantly greater improvement than the placebo group for all primary efficacy variables in comparisons of mean change from baseline to the end of treatment ( p < 0.05 ) . Improvement of > or = 50 % from baseline was demonstrated in at least one primary efficacy variable in 50 % of the active device group , in 2 variables in 32 % , and in all 3 variables in 24 % . In the placebo group improvement of > or = 50 % occurred in 36 % for one , 6 % for 2 , and 6 % for 3 variables . Mean morning stiffness decreased 20 min in the active device group and increased 2 min in the placebo group ( p < 0.05 ) . No statistically significant differences were observed for tenderness , swelling , or walking time . CONCLUSION The improvements in clinical measures for pain and function found in this study suggest that pulsed electrical stimulation is effective for treating OA of the knee . Studies for longterm effects are warranted
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 .