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 .
Does knee malalignment mediate the effects of quadriceps strengthening on knee adduction moment, pain, and function in medial knee osteoarthritis? A randomized controlled trial.
OBJECTIVE To examine whether the effects of 12 weeks of quadriceps strengthening on the knee adduction moment , pain , and function in people with medial knee osteoarthritis ( OA ) differ in those with and without varus malalignment . METHODS A single-blind , r and omized controlled trial of 107 community volunteers with medial knee OA was conducted . Participants were stratified according to knee malalignment ( more varus or more neutral ) and then r and omized into either a 12-week supervised home-based quadriceps strengthening group or a control group with no intervention . The primary outcome was the knee adduction moment , measured using 3-dimensional gait analysis . Secondary outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index scores ( measuring pain and physical function ) , step test score , stair climb test score , and maximum quadriceps isometric strength . Analyses of covariance were carried out based on intent-to-treat principles . RESULTS Quadriceps strengthening did not significantly alter the knee adduction moment in either the more malaligned or the more neutral group ( unadjusted knee adduction moment 0.12 and 0.05 % Nm/BWxHT , respectively ) . Function did not improve significantly following quadriceps strengthening in either alignment group , but there was a significant improvement in knee pain in the more neutrally aligned group ( P < 0.001 ) . CONCLUSION Quadriceps strengthening did not have any significant effect on the knee adduction moment in participants with either more varus or more neutral alignment . The benefits of quadriceps strengthening on pain were more evident in those with more neutral alignment . Knee alignment thus represents a local mechanical factor that can mediate symptomatic outcome from exercise interventions in knee OA
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 .