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 .
Pulsed Shortwave Treatment in Women With Knee Osteoarthritis: A Multicenter, Randomized, Placebo-Controlled Clinical Trial
Background Several forms of conservative treatment have been the focus of many recent studies in knee osteoarthritis ( OA ) . Among these techniques , the application of pulsed shortwave ( PSW ) treatment has been widely used , but the optimal dose and application time have not been well established . Objective The purpose s of this study were : ( 1 ) evaluate the effect of PSW treatment in different doses and ( 2 ) to compare low-dose and high-dose PSW groups with control and placebo groups . Design This was a r and omized clinical trial . Setting The study was conducted in the physical therapy department of 2 large urban hospitals . Patients One hundred twenty-one women ( mean age=60 years , SD=9 ) with a diagnosis of knee OA participated in the study . Intervention and Measurements Participants were distributed r and omly into 4 groups : 35 participants did not receive any treatment ( control group ) , 23 received a placebo treatment , 32 received low-dose PSW treatment ( power of 14.5 W , treatment duration of 19 minutes , and total energy of 17 kJ ) , and 31 received high-dose PSW treatment ( power of 14.5 W , treatment duration of 38 minutes , and total energy of 33 kJ ) . An 11-point numerical pain rating scale and the Knee Osteoarthritis Outcome Score were used to assess pain and function in 3 stages : at initial evaluation ( pretreatment ) , immediately after treatment , and at 12-month follow-up . Results The 4 groups were homogeneous prior to treatment with respect to demographics , pain , and functional scale data . The results demonstrated the short-term effectiveness of the PSW at low and high doses in patients with knee OA . Both treatment groups showed a significant reduction in pain and improvement in function compared with the control and placebo groups ( effect size : range=20.0–23.4 for the low-dose PSW group and range=15.7–16.5 for the high-dose PSW group ) . There were no differences in results between PSW doses , although a low dose of PSW appeared to be more effective in the long term . Limitations These results were achieved without physical exercise , which could have positively influenced the results . Conclusions Pulsed shortwave treatment is an effective method for pain relief and improvement of function and quality of life in the short term in women with knee OA . On the basis of the results , application of PSW treatment is recommended in the female population with knee OA . However , conclusions regarding the 12-month follow-up should be analyzed carefully due to the high dropout rate
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 .