Exercise as an intervention for osteoarthritis of the knee: A review of the literature

Objective: The objective of this review was to examine the evidence and provide recommendations for utilising therapeutic exercise in the treatment of osteoarthritis (OA) of the knee. Data sources: The PubMed Database was searched 07 July, 2011 for articles in English using the terms "osteoarthr*" AND "knee" AND each of the following, individually: Exercise; Strength; Resistance; Aerobic; Isometric; Isotonic; Isokinetic; Concentric; Eccentric; Aquatic; Dynamic; Balance; Agility; Tai Chi; and Yoga. The search excluded articles related to rehabilitation following arthroplasty. Clinical trials were the primary focus of the search. Study selection: The initial search identified 181 articles. Data extraction: Articles were eliminated if they were either redundant, not relevant, not in English, cost analyses, used an intervention other than exercise, or were not clinical trials. Reference lists were hand searched for additional articles not identified in the PubMed search and two studies known to the authors but not identified in the search were included. Data synthesis: A total of 91 trials were identified for inclusion in the narrative review. Conclusion: The literature strongly indicates various types of therapeutic exercise such as resistance training, walking, cycling, aquatic, Tai Chi, and balance and agility training are effective for reducing symptoms and improving function among persons with knee OA. Rehabilitation clinicians should consider factors such as patient preference, equipment availability, costs and presenting symptoms when designing exercise based rehabilitation programmes for patients with knee OA. [ABSTRACT FROM AUTHOR]