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 .
Preferences for heat, cold, or contrast in patients with knee osteoarthritis affect treatment response
Objective : This investigation assessed preferences for , and effects of , 5 days of twice daily superficial heat , cold , or contrast therapy applied with a commercially available system permitting the circulation of water through a wrap-around garment , use of an electric heating pad , or rest for patients with level II – IV osteoarthritis ( OA ) of the knee . Methods : We employed a within subject , r and omized order design to study 34 patients receiving each treatment in 1-week blocks . A knee injury and osteoarthritis outcome score ( KOOS ) question naire and visual analog pain scale was completed at baseline , and twice each week . Treatment preferences were assessed in the last week of the study . Results : Treatment with the device set to warm was preferred by 48 % of subjects . Near equal preferences were observed for cold ( 24 % ) and contrast ( 24 % ) . Pain reduction and improvements in KOOS subscale measures were demonstrated for each treatment but responses were ( P < 0.05 ) greater with preferred treatments . Most patients preferred treatment with the water circulating garment system over a heating pad . Conclusions : We recommend that when superficial heat or cold is considered in the management of knee OA that patients experiment to identify the intervention that offers them the greatest relief and that contrast is a treatment option
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 .