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 .
Effects of disinhibitory transcutaneous electrical nerve stimulation and therapeutic exercise on sagittal plane peak knee kinematics and kinetics in people with knee osteoarthritis during gait: a randomized controlled trial
Objective : To determine whether sensory transcutaneous electrical nerve stimulation ( TENS ) augmented with therapeutic exercise and worn for daily activities for four weeks would alter peak gait kinetics and kinematics , compared with placebo electrical stimulation and exercise , and exercise only . Design : R and omized controlled trial . Setting : Motion analysis laboratory . Subjects : Thirty-six participants with radiographically assessed knee osteoarthritis and volitional quadriceps activation below 90 % were r and omly assigned to electrical stimulation , placebo and comparison ( exercise-only ) groups . Interventions : Participants in all three groups completed a four-week quadriceps strengthening programme directed by an experienced rehabilitation clinician . Active electrical stimulation units and placebo units were worn in the electrical stimulation and placebo groups throughout the rehabilitation sessions as well as during all activities of daily living . Main measures : Peak external knee flexion moment and angle during stance phase were analysed at a comfortable walking speed before and after the intervention . Findings : Comfortable walking speed increased for all groups over time ( TENS 1.16 ± 0.15 versus 1.32 ± 0.16 m/s ; placebo 1.21 ± 0.34 versus 1.3 ± 0.24 m/s ; comparison 1.27 ± 0.18 versus 1.5 ± 0.14 m/s ) , yet no group differences in speed were found . No differences were found for peak flexion moment or angle between groups overtime . Conclusions : TENS in conjunction with therapeutic exercise does not seem to affect peak flexion moment and angle during stance over a four-week period in participants with tibiofemoral osteoarthritis
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 .