title: Ottawa panel evidence-based clinical practice guidelines for aerobic walking programs in the management of osteoarthritis.
abstract: OBJECTIVE
  To update the Evidence-Based Clinical Practice Guidelines (EBCPGs) on aerobic walking programs for the management of osteoarthritis (OA) of the knee.
  
  
  METHODS
  A literature search was conducted using the electronic databases MEDLINE, PubMed, and the Cochrane Library for all studies related to aerobic walking programs for OA from 1966 until February 2011.
  
  
  METHODS
  The literature search found 719 potential records, and 10 full-text articles were included according to the selection criteria. The Ottawa Methods Group established the inclusion and exclusion criteria regarding the characteristics of the population, by selecting adults of 40 years old and older who were diagnosed with OA of the knee.
  
  
  METHODS
  Two reviewers independently extracted important information from each selected study using standardized data extraction forms, such as the interventions, comparisons, outcomes, time period of the effect measured, and study design. The statistical analysis was reported using the Cochrane collaboration methods. An improvement of 15% or more relative to a control group contributes to the achievement of a statistically significant and clinically relevant progress. A specific grading system for recommendations, created by the Ottawa Panel, used a level system (level I for randomized controlled studies and level II for nonrandomized articles). The strength of the evidence of the recommendations was graded using a system with letters: A, B, C+, C, D, D+, or D-.
  
  
  RESULTS
  Evidence from 7 high-quality studies demonstrated that facility, hospital, and home-based aerobic walking programs with other therapies are effective interventions in the shorter term for the management of patients with OA to improve stiffness, strength, mobility, and endurance.
  
  
  CONCLUSIONS
  The greatest improvements were found in pain, quality of life, and functional status (grades A, B, or C+). A common limitation inherent to the EBCPGs is the heterogeneity of studies included with regards to the characteristics of the population, the interventions, the comparators, the outcomes, the period of time, and the study design. It is strongly recommended to use the Cochrane Risk of Bias Summary assessment to evaluate the methodologic quality of the studies and to consider avenues for future research on how aerobic walking programs would be beneficial in the management of OA of the hip.
authors.affiliation: School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ontario, Canada.
authors.forename: Laurianne
authors.initials: L
authors.lastname: Loew
authors.forename: Lucie
authors.initials: L
authors.lastname: Brosseau
authors.forename: George A
authors.initials: GA
authors.lastname: Wells
authors.forename: Peter
authors.initials: P
authors.lastname: Tugwell
authors.forename: Glen P
authors.initials: GP
authors.lastname: Kenny
authors.forename: Robert
authors.initials: R
authors.lastname: Reid
authors.forename: Andreas
authors.initials: A
authors.lastname: Maetzel
authors.forename: Maria
authors.initials: M
authors.lastname: Huijbregts
authors.forename: Carolyn
authors.initials: C
authors.lastname: McCullough
authors.forename: Gino
authors.initials: G
authors.lastname: De Angelis
authors.forename: Douglas
authors.initials: D
authors.lastname: Coyle
mesh_terms: D019317:Evidence-Based Medicine / Q000592:standards*; D015444:Exercise / Q000502:physiology*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D009864:Ontario; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000534:rehabilitation*; D017410:Practice Guidelines as Topic / Q000592:standards*; D016032:Randomized Controlled Trials as Topic; D012680:Sensitivity and Specificity; D016138:Walking / Q000502:physiology*