Ottawa Panel Evidence-Based Clinical Practice Guidelines for Aerobic Walking Programs in the Management of Osteoarthritis (original) (raw)

2012, Archives of Physical Medicine and Rehabilitation

This review concluded that aerobic walking programmes resulted in clinically-important improvements in pain relief, functional status, and quality of life in adults with knee osteoarthritis, although there was variation between included trials. Considering the uncertainty about the risk of bias in the included trials, the authors' conclusions and recommendations may be viewed as being too strong. Searching PubMed, EMBASE, CINAHL, PEDro, SCOPUS, BioMed, SUMSearch and The Cochrane Library were searched up to February 2011 for studies in English or French. The search strategy was reported as an appendix. Study selection Controlled studies of aerobic walking training in patients with knee osteoarthritis were eligible for inclusion. Patients had to be at least 40 years old and have a healthy body mass index (BMI) of below 25kg/m 2. Exercise interventions had to last for at least one month. A wide range of outcomes were eligible (listed in the paper). In most included studies patients performed supervised exercise. Some of the interventions also included multicomponent exercises or strength training. Most interventions were given two or three times a week for three months. Most of the control group treatments incorporated educational sessions. All studies included patients who satisfied radiographic or clinical criteria for their diagnosis. Mean ages of participants ranged from 56 to 76 years. Two reviewers selected studies, with disagreements resolved by a third reviewer. Assessment of study quality Two reviewers assessed study quality using the Jadad scale, resulting in a quality score between 0 and 5 points. Strength of evidence was graded using the Appraisal of Guidelines Research and Evaluation criteria.