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 .
Prehabilitation Before Total Knee Arthroplasty Increases Strength and Function in Older Adults With Severe Osteoarthritis
Swank , AM , Kachelman , JB , Bibeau , W , Quesada , PM , Nyl and , J , Malkani , A , and Topp , RV . Prehabilitation before total knee arthroplasty increases strength and function in older adults with severe osteoarthritis . J Strength Cond Res 25(2 ) : 318 - 325 , 2011-Preparing for the stress of total knee arthroplasty ( TKA ) surgery by exercise training ( prehabilitation ) may improve strength and function before surgery and , if effective , has the potential to contribute to postoperative recovery . Subjects with severe osteoarthritis ( OA ) , pain intractable to medicine and scheduled for TKA were r and omized into a usual care ( UC ) group ( n = 36 ) or usual care and exercise ( UC + EX ) group ( n = 35 ) . The UC group maintained normal daily activities before their TKA . The UC + EX group performed a comprehensive prehabilitation program that included resistance training using b and s , flexibility , and step training at least 3 times per week for 4 - 8 weeks before their TKA in addition to UC . Leg strength ( isokinetic peak torque for knee extension and flexion ) and ability to perform functional tasks ( 6-minute walk , 30 second sit-to-st and repetitions , and the time to ascend and descend 2 flights of stairs ) were assessed before r and omization at baseline ( T1 ) and 1 week before the subject 's TKA ( T2 ) . Repeated- measures analysis of variance indicated a significant group by time interaction ( p < 0.05 ) for the 30-second sit-to-st and repetitions , time to ascend the first flight of stairs , and peak torque for knee extension in the surgical knee . Prehabilitation increased leg strength and the ability to perform functional tasks for UC + EX when compared to UC before TKA . Short term ( 4 - 8 weeks ) of prehabilitation was effective for increasing strength and function for individuals with severe OA . The program studied is easily transferred to a home environment , and clinicians working with this population should consider prehabilitation before TKA
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 .