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 .
Progressive Resistance Training Improves Overall Physical Activity Levels in Patients With Early Osteoarthritis of the Knee: A Randomized Controlled Trial
Background Prescription of resistance training ( RT ) exercises is an essential aspect of management for knee osteoarthritis ( OA ) . However , whether patients with knee OA who are r and omly assigned to receive RT simply substitute RT for other modes of physical activity remains unclear . Objective The aim of this study was to determine the effect of a structured RT intervention on overall levels of moderate- and vigorous-intensity physical activity ( MVPA ) in patients with early-onset knee OA . The study compared patients with early-onset OA who participated in an RT program , those who participated in a self-management ( SM ) program  , and those who participated in both RT and SM . Because participants r and omly assigned to receive the RT intervention may simply switch activity modes , result ing in little net effect , we assessed total MVPA in addition to tracking changes in strength ( force-generating capacity ) . Design and Intervention This study was a r and omized controlled trial comparing the effectiveness of SM alone , RT alone , and combined RT+SM on MVPA in patients with early OA of the knee . Setting The study was conducted on a university campus , with patient recruitment from the local community . Participants The participants in this study were 171 patients ( 74 % women , 26 % men ) with knee OA . They had a mean age of 55.1 ( SD=7.1 ) years , a mean body mass index of 27.6 ( SD=4.2 ) kg/m2 , and radiographic status of grade II OA ( and no higher ) in at least one knee , as defined by the Kellgren and Lawrence classification . They wore an accelerometer while awake ( X̄=14.2 [ SD=2.2 ] hours ) for 5 to 7 contiguous days ( X̄=6.8 [ SD=0.5 ] days ) at baseline and at 3 and 9 months of intervention . Results The participants engaged in MVPA a mean of 26.2 ( SD=19.3 ) minutes per day at baseline . Both groups significantly increased their MVPA from baseline to 3 months ( RT group by 18 % [ effect size (d)=0.26 ] ; SM group by 22 % [ effect size (d)=0.25 ] ) , but only the RT group sustained those changes at 9 months ( RT group maintained a 10 % increase [ effect size (d)=0.15 ] ; SM group maintained a 2 % increase [ effect size (d)=0.03 ] ) . A significant group × time interaction for MVPA indicated that the RT group maintained higher MVPA levels than the SM group . Limitations . Lack of direct measures of energy expenditure and physical function was a limitation of the study . Conclusions Patients with early-onset OA of the knee can engage in an RT program without sacrificing their overall MVPA levels . These results support the value of RT for management of 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 .