Therapeutic exercise is a recommended first‐line treatment for people with knee and hip osteoarthritis. However, there is little specific advice or practical resources to guide clinicians in its implementation. As the first in a series of projects by the Osteoarthritis Research Society International Rehabilitation Discussion Group to address this gap, we aim to synthesize current literature informing the implementation of therapeutic exercise for people with knee and hip osteoarthritis. A narrative review is focusing on evidence from systematic reviews and randomized controlled trials.

Therapeutic exercise is safe for people with knee and hip osteoarthritis. Numerous therapeutic exercises (including aerobic, strengthening, neuromuscular, mind‐body exercise) may be utilized at varying doses and in different settings to improve pain and function. Benefits from therapeutic exercise appear greater when dosage recommendations from general exercise guidelines for healthy adults are met. However, interim therapeutic exercise goals may also be useful, given that many barriers to achieving these dosages exist among this patient group. Theoretically‐informed strategies to improve adherence to therapeutic exercises, such as patient education, goal setting, monitoring, and feedback, may help maintain participation and optimize clinical benefits over the longer‐term. Sedentary behavior is also a risk factor for disability and lower quality of life in people with knee and hip osteoarthritis, although limited evidence exists regarding how best to reduce this behavior.

Current evidence can be used to inform how to implement best practice therapeutic exercise, at a sufficient and appropriate dose, for people with knee and hip osteoarthritis.