ABSTRACT
OBJECTIVE:: To identify programmes involving therapeutic exercise that are effective for the management of hand osteoarthritis and to provide stakeholders with updated, moderate to high-quality recommendations supporting exercises for hand osteoarthritis. METHODS:: A systematic search and adapted selection criteria included comparable trials with exercise programmes for managing hand osteoarthritis. Based on the evaluated evidence, a panel of experts reached consensus through a Delphi approach endorsing the recommendations. A hierarchical alphabetical grading system (A, B, C+, C, C-, D-, D, D+, E, F) was based on clinical importance (≥15%) and statistical significance ( P < 0.05). RESULTS:: Ten moderate- to high-quality studies were included. Eight studies with programmes involving therapeutic exercise (e.g. range of motion (ROM) + isotonic + isometric + functional exercise) seemed to be effective. Forty-six positive grade recommendations (i.e. A, B, C+) were obtained during short-term (<12 weeks) trials for pain, stiffness, physical function, grip strength, pinch strength, range of motion, global assessment, pressure pain threshold, fatigue and abductor pollicis longus moment and during long-term (>12 weeks) trials for physical function and pinch strength. CONCLUSION:: Despite that many programmes involving exercise with positive recommendations for clinical outcomes are available to healthcare professionals and hand osteoarthritis patients that aid in the management of hand osteoarthritis, there is a need for further research to isolate the specific effect of exercise components.
Subject(s)
Exercise Therapy/methods , Exercise Therapy/standards , Osteoarthritis/rehabilitation , Consensus , Evidence-Based Medicine , Hand/physiopathology , Humans , Osteoarthritis/physiopathology , Pain Management , Pinch Strength , Randomized Controlled Trials as Topic , Range of Motion, Articular , Systematic Reviews as TopicABSTRACT
OBJECTIVE: To identify effective mind-body exercise programs and provide clinicians and patients with updated, high-quality recommendations concerning non-traditional land-based exercises for knee osteoarthritis. METHODS: A systematic search and adapted selection criteria included comparative controlled trials with mind-body exercise programs for patients with knee osteoarthritis. A panel of experts reached consensus on the recommendations using a Delphi survey. A hierarchical alphabetical grading system (A, B, C+, C, D, D+, D-) was used, based on statistical significance ( P < 0.5) and clinical importance (⩾15% improvement). RESULTS: The four high-quality studies identified demonstrated that various mind-body exercise programs are promising for improving the management of knee osteoarthritis. Hatha Yoga demonstrated significant improvement for pain relief (Grade B) and physical function (Grade C+). Tai Chi Qigong demonstrated significant improvement for quality of life (Grade B), pain relief (Grade C+) and physical function (Grade C+). Sun style Tai Chi gave significant improvement for pain relief (Grade B) and physical function (Grade B). CONCLUSION: Mind-body exercises are promising approaches to reduce pain, as well as to improve physical function and quality of life for individuals with knee osteoarthritis.
Subject(s)
Evidence-Based Medicine , Exercise Therapy/standards , Mind-Body Therapies/standards , Osteoarthritis, Knee/rehabilitation , Pain Management/methods , Exercise Therapy/methods , Humans , Mind-Body Therapies/methods , Muscle Strength/physiology , Practice Guidelines as TopicABSTRACT
OBJECTIVES: To identify effective aerobic exercise programs and provide clinicians and patients with updated, high-quality recommendations concerning traditional land-based exercises for knee osteoarthritis. METHODS: A systematic search and adapted selection criteria included comparative controlled trials with strengthening exercise programs for patients with knee osteoarthritis. A panel of experts reached consensus on the recommendations using a Delphi survey. A hierarchical alphabetical grading system (A, B, C+, C, D, D+, or D-) was used, based on statistical significance ( P < 0.5) and clinical importance (⩾15% improvement). RESULTS: The five high-quality studies included demonstrated that various aerobic training exercises are generally effective for improving knee osteoarthritis within a 12-week period. An aerobic exercise program demonstrated significant improvement for pain relief (Grade B), physical function (Grade B) and quality of life (Grade C+). Aerobic exercise in combination with strengthening exercises showed significant improvement for pain relief (3 Grade A) and physical function (2 Grade A, 2 Grade B). CONCLUSION: A short-term aerobic exercise program with/without muscle strengthening exercises is promising for reducing pain, improving physical function and quality of life for individuals with knee osteoarthritis.
Subject(s)
Evidence-Based Medicine , Exercise Therapy/standards , Exercise/physiology , Osteoarthritis, Knee/rehabilitation , Pain Management/methods , Exercise Therapy/methods , Humans , Practice Guidelines as TopicABSTRACT
OBJECTIVE: To identify effective strengthening exercise programs and provide rehabilitation teams and patients with updated, high-quality recommendations concerning traditional land-based exercises for knee osteoarthritis. METHODS: A systematic search and adapted selection criteria included comparative controlled trials with strengthening exercise programs for patients with knee osteoarthritis. A panel of experts reached consensus on the recommendations using a Delphi survey. A hierarchical alphabetical grading system (A, B, C+, C, D, D+ or D-) was based on statistical significance ( p < 0.5) and clinical importance (⩾15% improvement). RESULTS: The 26 high-quality studies identified demonstrated that various strengthening exercise programs with/without other types of therapeutic exercises are generally effective for improving knee osteoarthritis management within a six-month period. Strengthening exercise programs demonstrated a significant improvement for pain relief (four Grade A, ten Grade B, two Grade C+), physical function (four Grade A, eight Grade B) and quality of life (three Grade B). Strengthening in combination with other types of exercises (coordination, balance, functional) showed a significant improvement in pain relief (three Grade A, 11 Grade B, eight Grade C+), physical function (two Grade A, four Grade B, three Grade C+) and quality of life (one Grade A, one Grade C+). CONCLUSION: There are a variety of choices for strengthening exercise programs with positive recommendations for healthcare professionals and knee osteoarthritis patients. There is a need to develop combined behavioral and muscle-strengthening strategies to improve long-term maintenance of regular strengthening exercise programs.
Subject(s)
Evidence-Based Medicine , Muscle Stretching Exercises/standards , Osteoarthritis, Knee/rehabilitation , Pain Management/methods , Resistance Training/standards , Exercise Therapy/methods , Exercise Therapy/standards , Humans , Muscle Stretching Exercises/methods , Practice Guidelines as Topic , Resistance Training/methodsABSTRACT
Purpose: the purpose of the article is to produce a French-Canadian translation of the "OA Go Away" tool and to assess the validity of its contents as well as its test-retest reliability. "OA Go Away" is a customized tool that measures the various symptoms, their impact, and the physical activities of people with osteoarthritis of the hip or knee to improve self-care and help them be physically active. Method: Vallerand's cross-cultural validation methodology was used. First, professional translators and rehabilitation professionals produced a parallel reverse translation of the "OA Go Away" tool. Then, a committee of experts examined the translated versions and created a first experimental draft of the "Au revoir arthrose" tool. This draft was assessed and modified by a second committee of experts. Three users with osteoarthritis of the knee then assessed this version. Finally, a linguist examined the draft and an expert produced a final reverse translation of that version. The main co-researchers proposed final modifications of that version. Results: Twenty-one users indicated that the wording of the final "Au revoir arthrose" version was clear. The test-retest reliability was acceptable for the main elements of the "Au revoir arthrose" journal. Conclusions: The process's five rigorous steps enabled the creation of a valid French-Canadian version of the "Au revoir arthrose" tool. On average, the French-Canadian version of the "Au revoir arthrose" tool has moderate test-retest reliability for all of its elements. This tool can prove to be relevant for people suffering from osteoarthritis of the hip or knee, motivating them to be physically active, and for the health professionals who care for them.