Cited by 108Musculoskeletal pain and rehabilitationOsteoarthritis Treatment and MechanismsLower Extremity Biomechanics and Pathologies

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Physical Therapy Interventions for Knee Pain Secondary to Osteoarthritis: A Systematic Review

Wang, Shi-Yi, Olson-Kellogg, Becky, Shamliyan, Tatyana A., Choi, Jae-Young, Ramakrishnan, Rema, Kane, Robert L.·2012·Annals of Internal Medicine

DOI 10.7326/0003-4819-157-9-201211060-00007

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Abstract

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. DATA SOURCES: MEDLINE, the Cochrane Library, the Physiotherapy Evidence Database, Scirus, Allied and Complementary Medicine, and the Health and Psychosocial Instruments bibliography database. STUDY SELECTION: 193 randomized, controlled trials (RCTs) published in English from 1970 to 29 February 2012. DATA EXTRACTION: Means of outcomes, PT interventions, and risk of bias were extracted to pool standardized mean differences. Disagreements between reviewers abstracting and checking data were resolved through discussion. DATA SYNTHESIS: Meta-analyses of 84 RCTs provided evidence for 13 PT interventions on pain (58 RCTs), physical function (36 RCTs), and disability (29 RCTs). Meta-analyses provided low-strength evidence that aerobic (11 RCTs) and aquatic (3 RCTs) exercise improved disability and that aerobic exercise (19 RCTs), strengthening exercise (17 RCTs), and ultrasonography (6 RCTs) reduced pain and improved function. Several individual RCTs demonstrated clinically 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. LIMITATION: Variability in PT interventions and outcomes measures hampered synthesis of evidence. CONCLUSION: Low-strength evidence suggested that only a few PT interventions were effective. Future studies should compare combined PT interventions (which is how PT is generally administered for pain associated with knee osteoarthritis). PRIMARY FUNDING SOURCE: Agency for Healthcare Research and Quality.

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Authors: Wang, S.-Y., Olson-Kellogg, B., Shamliyan, T. A., Choi, J.-Y., Ramakrishnan, R., & Kane, R. L.
Affiliations: University of Minnesota (US)
ORCID: Wang, Shi-Yi
Shamliyan, Tatyana A.
Choi, Jae-Young
Ramakrishnan, Rema
Kane, Robert L.
Venue: Annals of Internal Medicine
Publisher: American College of Physicians
Published: 2012-11-06
Volume: 157
Issue: 9
Pages: 632-644
ISSN: 0003-4819 (ISSN-L)
1539-3704
DOI: 10.7326/0003-4819-157-9-201211060-00007
OpenAlex: W2099742401
Cited by: 108
References: 169
Citations by year: 2026: 3 · 2025: 5 · 2024: 7 · 2023: 9 · 2022: 5 · 2021: 8 · 2020: 3 · 2019: 4 · 2018: 10 · 2017: 6 · 2016: 10 · 2015: 14 · 2014: 12 · 2013: 11
FWCI: 1.37
Type: journal article
Language: en
Open access: closed
Licence: www.acpjournals.org/journal/aim/text-and-data-mining (tdm)
Locations: Annals of Internal Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Public Health Service (290-2007-10064 I)
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
Keywords: knee osteoarthritis, knee pain, physical therapy intervention, aerobic exercise, aquatic exercise, resistance training, ultrasonography, physical function, disability, conservative treatment, community-dwelling adults
MeSH terms: Humans, Quality of Life, Randomized Controlled Trials as Topic, Osteoarthritis, Knee, Physical Therapy Modalities, Comparative Effectiveness Research, Pain Management

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Physical Therapy Interventions for Knee Pain Secondary to Osteoarthritis: A Systematic Review

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