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 .
Use of ultrasound to increase effectiveness of isokinetic exercise for knee osteoarthritis.
OBJECTIVE To investigate the effects of ultrasound ( US ) in isokinetic muscle strengthening exercises on functional status of patients with knee osteoarthritis ( OA ) . DESIGN Effectiveness of isokinetic muscle strengthening exercises for treatment of periarticular soft tissue disorders was compared with and without pulsed and continuous US . SETTING Outpatient exercise program in a Taiwan medical university hospital . PARTICIPANTS One hundred twenty subjects with bilateral knee OA ( Altman grade II ) . INTERVENTION Subjects were r and omized sequentially into 1 of 4 groups . Group I received isokinetic muscular strengthening exercises , group II received isokinetic exercise and continuous US , group III received isokinetic exercise and pulsed US treatment , and group IV was the control group . MAIN OUTCOME MEASURES Therapeutic effects of isokinetic exercise  were evaluated by changes in ambulation speed and the Lequesne index . In addition , changes in knee range of motion ( ROM ) , visual analog scale for pain , and muscle peak torques during knee flexion and extension were compared . Compliance in each group was recorded . RESULTS Each treated group had increased muscle peak torques and significantly reduced pain and disability after treatment and at follow-up . However , only patients in groups II and III had significant improvement in ROM and ambulation speed after treatment . Fewer participants in group III discontinued treatment due to knee pain during exercise . Patients in group III also showed the greatest increase in walking speed and decrease in disability after treatment and at follow-up . Gains in muscular strength in 60 degrees /s angular velocity peak torques were also noted in groups II and III . However , group III showed the greatest muscular strength gains with 180 degrees /s angular velocity peak torques after treatment and follow-up . CONCLUSIONS US treatment could increase the effectiveness of isokinetic exercise for functional improvement of knee OA , and pulsed ultrasound has a greater effect than continuous US
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 .