title: Educating patients about the benefits of physical activity and exercise for their hip and knee osteoarthritis. Systematic literature review.
abstract: OBJECTIVE
  Highlight the role of patient education about physical activity and exercise in the treatment of hip and knee osteoarthritis (OA).
  
  
  METHODS
  Systematic literature review from the Cochrane Library, PubMed and Wiley Online Library databases. A total of 125 items were identified, including 11 recommendations from learned societies interested in OA and 45 randomized controlled trials addressing treatment education and activity/exercise for the treatment of hip and knee osteoarthritis.
  
  
  RESULTS
  In the end, 13 randomized controlled trials and 8 recommendations were reviewed (1b level of evidence). Based on the analysis, it was clear that education, exercise and weight loss are the pillars of non-pharmacological treatments. These treatments have proven to be effective but require changes in patient behaviour that are difficult to obtain. Exercise and weight loss improve function and reduce pain. Education potentiates compliance to exercise and weight loss programs, thereby improving their long-term benefits. Cost efficiency studies have found a reduction in medical visits and healthcare costs after 12 months because of self-management programs.
  
  
  CONCLUSIONS
  Among non-surgical treatment options for hip and knee osteoarthritis, the most recent guidelines focus on non-pharmacological treatment. Self-management for general physical activity and exercise has a critical role. Programs must be personalized and adjusted to the patient's phenotype. This development should help every healthcare professional adapt the care they propose to each patient. Registration number for the systematic review: CRD42015032346.
authors.affiliation: Service de Médecine Physique et de Réadaptation, CHU de Clermont-Ferrand, Hôpital Nord, route de Chateaugay, BP 30056, 63118 Cébazat, France; Université Clermont Auvergne, 63003 Clermont-Ferrand, France; Unité de Nutrition Humaine, INRA, UMR 1019, CRNH Auvergne, 63000 Clermont-Ferrand, France.
authors.forename: C
authors.initials: C
authors.lastname: Gay
authors.affiliation: Service de Médecine Physique et de Réadaptation, CHU de Clermont-Ferrand, Hôpital Nord, route de Chateaugay, BP 30056, 63118 Cébazat, France; Université Clermont Auvergne, 63003 Clermont-Ferrand, France.
authors.forename: A
authors.initials: A
authors.lastname: Chabaud
authors.affiliation: Service de Médecine Physique et de Réadaptation, CHU de Clermont-Ferrand, Hôpital Nord, route de Chateaugay, BP 30056, 63118 Cébazat, France.
authors.forename: E
authors.initials: E
authors.lastname: Guilley
authors.affiliation: Service de Médecine Physique et de Réadaptation, CHU de Clermont-Ferrand, Hôpital Nord, route de Chateaugay, BP 30056, 63118 Cébazat, France; Université Clermont Auvergne, 63003 Clermont-Ferrand, France; Unité de Nutrition Humaine, INRA, UMR 1019, CRNH Auvergne, 63000 Clermont-Ferrand, France. Electronic address: ecoudeyre@chu-clermontferrand.fr.
authors.forename: E
authors.initials: E
authors.lastname: Coudeyre
mesh_terms: D000328:Adult; D015444:Exercise; D005081:Exercise Therapy / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000523:psychology / Q000628:therapy*; D020370:Osteoarthritis, Knee / Q000523:psychology / Q000628:therapy*; D010349:Patient Compliance; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D012648:Self Care / Q000379:methods
keywords: Exercise; Hip and osteoathritis; Knee; Self-care; Self-efficacy and physical activity; Self-management