title: The clinical effectiveness of self-care interventions with an exercise component to manage knee conditions: A systematic review.
abstract: OBJECTIVE
  Treatment of knee conditions should include approaches to support self-care and exercise based interventions. The most effective way to combine self-care and exercise has however not been determined sufficiently. Therefore the aim was to evaluate the clinical effectiveness of self-care programmes with an exercise component for individuals with any type of knee conditions.
  
  
  METHODS
  A keyword search of Medline, CINAHL, Amed, PsycInfo, Web of Science, and Cochrane databases was conducted up until January 2015. Two reviewers independently assessed manuscript eligibility against inclusion/exclusion criteria. Study quality was assessed using the Downs and Black quality assessment tool and the Cochrane Risk of Bias Tool. Data were extracted about self-care and exercise intervention type, control intervention, participants, length of follow-up, outcome measures, and main findings.
  
  
  RESULTS
  From the 7392 studies identified through the keyword search the title and abstract of 5498 were screened. The full text manuscripts of 106 studies were retrieved to evaluate their eligibility. Twenty-one manuscripts met the inclusion/exclusion criteria.
  
  
  CONCLUSIONS
  The treatment potential of combined self-care and exercise interventions has not been maximised because of limitations in study design and failure to adequately define intervention content. Potentially the most beneficial self-care treatment components are training self-management skills, information delivery, and goal setting. Exercise treatment components could be strengthened by better attention to dose and progression. Modern technology to streamline delivery and support self-care should be considered. More emphasis is required on using self-care and exercise programmes for chronic condition prevention in addition to chronic condition management.
authors.affiliation: School of Healthcare Sciences, Cardiff University, United Kingdom; Physiotherapy Department, Cardiff and Vale UHB, United Kingdom. Electronic address: buttonk@cardiff.ac.uk.
authors.forename: Kate
authors.initials: K
authors.lastname: Button
authors.affiliation: School of Healthcare Sciences, Cardiff University, United Kingdom.
authors.forename: Paulien E
authors.initials: PE
authors.lastname: Roos
authors.affiliation: School of Computer Science and Informatics, Cardiff University, United Kingdom.
authors.forename: Irena
authors.initials: I
authors.lastname: Spasić
authors.affiliation: School of Healthcare Sciences, Cardiff University, United Kingdom; Physiotherapy Department, Cardiff and Vale UHB, United Kingdom.
authors.forename: Paul
authors.initials: P
authors.lastname: Adamson
authors.affiliation: School of Healthcare Sciences, Cardiff University, United Kingdom.
authors.forename: Robert W M
authors.initials: RW
authors.lastname: van Deursen
mesh_terms: D059549:Anterior Cruciate Ligament Reconstruction / Q000534:rehabilitation*; D018771:Arthralgia / Q000628:therapy*; D059350:Chronic Pain / Q000628:therapy*; D005081:Exercise Therapy; D006801:Humans; D020370:Osteoarthritis, Knee / Q000628:therapy*; D012648:Self Care
keywords: Exercise; Knee; Patient education; Rehabilitation; Self-care