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 .
Effect of Home Exercise of Quadriceps on Knee Osteoarthritis Compared with Nonsteroidal Antiinflammatory Drugs: A Randomized Controlled Trial
Doi T , Akai M , Fujino K , Iwaya T , Kurosawa H , Hayashi K , Marui E : Effect of home exercise of quadriceps on knee osteoarthritis compared with nonsteroidal antiinflammatory drugs : a r and omized controlled trial . Am J Phys Med Rehabil 2008;87:258–269 . Objectives : To examine the effect of home-based exercise on  knee osteoarthritis among Japanese in comparison with that of nonsteroidal antiinflammatory drugs ( NSAIDs ) . Design : An open-labeled , r and omized , controlled , multiclinic trial compared home-based quadriceps exercise with NSAIDs . Treatments were basically evaluated after 8 wks and compared with the baseline scores . Outcomes were evaluated with a set of psychometric measurements including the Western Ontario and McMaster Universities Arthritis Index ( WOMAC ) , 36-Item Short-Form Health Survey ( SF-36 ) , Japanese Knee Osteoarthritis Measure ( JKOM ) , and pain with the visual analog scale . Results : A total of 142 patients entered this trial to provide the baseline data . After 21 cases withdrew , the final number analyzed was 121 cases : 63 for the exercise group and 58 for the NSAIDs group . Between these two groups , there was no significant difference in gender , age , body height and weight , body mass index , or each score at baseline . The subjects in both groups showed improvements in all scores at the end of intervention . The difference in improvement rate of each score between the two groups was not statistically significant , though the mean rank score measured with JKOM in the exercise was slightly better than that of the NSAIDs . Conclusions : Home-based exercise using quadriceps strengthening improves knee osteoarthritis no less than NSAIDs
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 .