Exercise Therapy Recommended to Manage Knee Osteoarthritis

A recent pilot trial found that a cognitive-behavioral intervention may be superior to traditional exercise therapy in improving physical activity in sedentary individuals with knee OA over one year.²⁵ The group receiving the cognitive-behavioral intervention participated in sessions over the course of nine months, and the traditional center-based supervised exercise therapy received three visits per week for three months.²⁵ Because of the differences in timing of face-to-face treatment sessions, it’s again difficult to ascertain whether the differences in effects were due to the nature of the intervention itself or the timing of its delivery.

Another recent study employed a novel Internet-based physical activity promotion program for individuals with knee and/or hip OA.²⁶ Self-reported physical activity was higher after 12 months for the intervention group compared with the waiting control group. Such a program is an intriguing option, because it does not require in-person visits to complete and, thus, may be substantially more accessible and less expensive than alternatives. However, the results of this study should be interpreted with caution due to high rates of nonadherence and dropouts.

Conclusion

Although a variety of rehabilitation strategies involving exercise have been effective at improving pain, function and quality of life for individuals with knee OA, further research is necessary to determine the optimal mode, dosage and level of supervision required for exercise therapy.

In addition, manual therapy, booster sessions and physical activity promotion programs should continue to be studied to further illuminate their potential roles in providing and maintaining treatment effects over time.

Allyn M. Bove, PT, DPT, is an assistant professor in the Department of Physical Therapy at the University of Pittsburgh School of Health and Rehabilitation Sciences. She received B.S. degrees in Biology and Health Sciences from Duquesne University in Pittsburgh and a Doctor of Physical Therapy degree from Columbia University in New York, and is currently completing PhD studies at the University of Pittsburgh. Her research interests include racial disparities related to knee OA, total knee arthroplasty and cost effectiveness of non-surgical treatments for knee OA.

G. Kelley Fitzgerald, PT, PhD, FAPTA, is professor and associate dean of graduate studies at the University of Pittsburgh School of Health and Rehabilitation Sciences and serves as director of the Physical Therapy Clinical and Translational Research Center. He has earned degrees from the University of Illinois, Chicago Medical School, Virginia Commonwealth University, and the Medical College of Pennsylvania/Hahnemann University. He has more than 26 years of experience as a physical therapy clinical researcher and focuses his research on knee OA.

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