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 .
Validity and Responsiveness of the Knee Society Clinical Rating System in Comparisonwith the SF-36 and WOMAC
Background : The aim of this study was to vali date the Knee Society Clinical Rating System ( knee and function scores ) and to compare its responsiveness with that of the Western Ontario and McMaster University Osteoarthritis Index ( WOMAC ) and the Medical Outcomes Study Short Form-36 ( SF-36 ) . Methods : Patients were recruited as part of a prospect i ve observational study of the outcomes of primary total knee arthroplasty for the treatment of osteoarthritis in four centers in the United States , six centers in the United Kingdom , and two centers in Australia . Independent research assistants at each site collected the Knee Society clinical data . The WOMAC , SF-36 , patient satisfaction , and demographic data were obtained with self-administered question naires . Results : A total of 862 eligible patients were recruited , and complete preoperative and twelve-month data were available for 697 ( 80.9 % ) of them . The mean age was seventy years ( range , thirty-eight to ninety years ) , and the majority of the patients ( 58.9 % ) were women . Low correlations were found among the items of both the knee and the function score at both assessment times . The Knee Society pain and function scores had moderate-to-strong correlations with the corresponding pain and function domains of the WOMAC and SF-36 ( r = 0.31 to 0.72 ) . Measurement of the st and ardized response mean showed the  Knee Society knee score to be more responsive ( st and ardized response mean , 2.2 ) than the WOMAC ( st and ardized response means , 2.0 for pain and 1.4 for function ) and the SF-36 ( st and ardized response means , 1.0 for bodily pain and 1.1 for physical functioning ) . The Knee Society function score was the least responsive measure ( st and ardized response mean , 0.8 ) . Correlation of changes in scores at twelve months with patient reports of satisfaction and improvement in health status showed the WOMAC and SF-36 to be more responsive than the Knee Society scores . Conclusions : There is a poor correlation among the items of the Knee Society Clinical Rating System , but the rating system has adequate convergent construct validity . The WOMAC and SF-36 are more responsive measures of outcome of total knee arthroplasty . As they are less labor-intensive for research ers to use and as use of these instruments removes observer bias from the study design , they are preferable for knee arthroplasty outcome studies
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 .