title: EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis.
abstract: The objective was to develop evidence -based recommendations and a research and educational agenda for the non-pharmacological management of hip and knee osteoarthritis (OA). The multidisciplinary task force comprised 21 experts: nurses, occupational therapists, physiotherapists, rheumatologists, orthopaedic surgeons, general practitioner, psychologist, dietician, clinical epidemiologist and patient representatives. After a preliminary literature review, a first task force meeting and five Delphi rounds, provisional recommendations were formulated in order to perform a systematic review. A literature search of Medline and eight other databases was performed up to February 2012. Evidence was graded in categories I-IV and agreement with the recommendations was determined through scores from 0 (total disagreement) to 10 (total agreement). Eleven evidence-based recommendations for the non-pharmacological core management of hip and knee OA were developed, concerning the following nine topics: assessment, general approach, patient information and education, lifestyle changes, exercise, weight loss, assistive technology and adaptations, footwear and work. The average level of agreement ranged between 8.0 and 9.1. The proposed research agenda included an overall need for more research into non-pharmacological interventions for hip OA, moderators to optimise individualised treatment, healthy lifestyle with economic evaluation and long-term follow-up, and the prevention and reduction of work disability. Proposed educational activities included the required skills to teach, initiate and establish lifestyle changes. The 11 recommendations provide guidance on the delivery of non-pharmacological interventions to people with hip or knee OA. More research and educational activities are needed, particularly in the area of lifestyle changes.
authors.affiliation: National Resource Center for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. linda.fernandes1@gmail.com
authors.forename: Linda
authors.initials: L
authors.lastname: Fernandes
authors.forename: Kåre B
authors.initials: KB
authors.lastname: Hagen
authors.forename: Johannes W J
authors.initials: JW
authors.lastname: Bijlsma
authors.forename: Oyvor
authors.initials: O
authors.lastname: Andreassen
authors.forename: Pia
authors.initials: P
authors.lastname: Christensen
authors.forename: Philip G
authors.initials: PG
authors.lastname: Conaghan
authors.forename: Michael
authors.initials: M
authors.lastname: Doherty
authors.forename: Rinie
authors.initials: R
authors.lastname: Geenen
authors.forename: Alison
authors.initials: A
authors.lastname: Hammond
authors.forename: Ingvild
authors.initials: I
authors.lastname: Kjeken
authors.forename: L Stefan
authors.initials: LS
authors.lastname: Lohmander
authors.forename: Hans
authors.initials: H
authors.lastname: Lund
authors.forename: Christian D
authors.initials: CD
authors.lastname: Mallen
authors.forename: Tiziana
authors.initials: T
authors.lastname: Nava
authors.forename: Susan
authors.initials: S
authors.lastname: Oliver
authors.forename: Karel
authors.initials: K
authors.lastname: Pavelka
authors.forename: Irene
authors.initials: I
authors.lastname: Pitsillidou
authors.forename: José Antonio
authors.initials: JA
authors.lastname: da Silva
authors.forename: Jenny
authors.initials: J
authors.lastname: de la Torre
authors.forename: Gustavo
authors.initials: G
authors.lastname: Zanoli
authors.forename: Theodora P M
authors.initials: TP
authors.lastname: Vliet Vlieland
mesh_terms: D026683:Advisory Committees; D003697:Delphi Technique; D019317:Evidence-Based Medicine; D005081:Exercise Therapy; D006801:Humans; D015207:Osteoarthritis, Hip / Q000628:therapy*; D020370:Osteoarthritis, Knee / Q000628:therapy*; D010353:Patient Education as Topic; D012656:Self-Help Devices; D061217:Weight Reduction Programs
keywords: Nursing; Occupational therapy; Osteoarthritis; Physcial therapy; Psychology