British medical bulletin 2017 05 03() 1-11 doi 10.1093/bmb/ldx012
Osteoarthritis (OA) of the lower limb affects millions of people worldwide, and results in pain and reduced function. We reviewed guidelines and Cochrane reviews for physical therapy interventions to manage the condition.
Sources of data
Evidence from meta-analyses and systematic reviews was included. We also identified the recommendations from guidelines relevant to practice in the UK.
Areas of agreement
There is strongest evidence to support the use of exercise to improve pain, function and quality of life.
Areas of controversy
There is limited evidence to support the use of some commonly utilized physiotherapy interventions. National Institute for Health and Clinical Excellence do not recommend the use of acupuncture.
Programmes that include single exercise type may be more beneficial than combined strengthening and aerobic interventions.
Areas timely for developing research
Further research is required to determine how to facilitate long-term engagement with exercise to sustain the beneficial effects on pain, function and quality of life. Studies that investigate packages of care, combining interventions require further investigation.