The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part three: aerobic exercise programs.
OBJECTIVE
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).


CONCLUSIONS
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.
1 Physiotherapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Lucie
L
Brosseau
2 Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Jade
J
Taki
3 School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.
Brigit
B
Desjardins
3 School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.
Odette
O
Thevenot
4 Faculty of Health Sciences, University of Sydney, Sydney, Australia.
Marlene
M
Fransen
5 School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada.
George A
GA
Wells
6 UNIFESP, Internal Medicine, Brasilia, Brazil.
Aline
A
Mizusaki Imoto
7 Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, Faculty of Medicine and School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Karine
K
Toupin-April
8 Mary Pack Arthritis Program, Vancouver Coastal Health, Department of Physical Therapy, University of British Columbia, Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada.
Marie
M
Westby
9 Department of Physical Education and Sport, University of Granada, Granada, Spain.
Inmaculada C
IC
Álvarez Gallardo
10 School of Nursing, University of Ottawa, Ottawa, Ontario, Canada.
Wendy
W
Gifford
11 Canadian Forces Health Services Group Headquarters, National Defense, Ottawa, Ontario, Canada.
Lucie
L
Laferrière
12 Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
Prinon
P
Rahman
13 School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Laurianne
L
Loew
13 School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Gino
G
De Angelis
13 School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Sabrina
S
Cavallo
13 School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Shirin Mehdi
SM
Shallwani
13 School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Ala'
A
Aburub
14 Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia.
Kim L
KL
Bennell
15 Department of Rehabilitation, Reade Centre for Rehabilitation and Rheumatology, Amsterdam, Netherlands, Faculty of Health. ACHIEVE, Centre of Applied Research and School of Physiotherapy, University of Applied Sciences, Amsterdam, Netherlands.
Martin
M
Van der Esch
16 Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia.
Milena
M
Simic
17 Department of Medicine, St. Joseph's Health Care Centre, Toronto, Ontario, Canada.
Sara
S
McConnell
1 Physiotherapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Alison
A
Harmer
3 School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.
Glen P
GP
Kenny
18 The Arthritis Society, Ottawa Office, Ontario Division, Ottawa, Ontario, Canada.
Gail
G
Paterson
19 Centre de recherche Epidémiologie et Biostatistique, Hôpital Hôtel-Dieu, Paris, France.
Jean-Philippe
JP
Regnaux
20 Institute of Rheumatology, Department of Medicine and Rehabilitation, Cochin Hospital, Paris, France.
Marie-Martine
MM
Lefevre-Colau
1 Physiotherapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Linda
L
McLean
D019317:Evidence-Based Medicine; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods / Q000592:standards*; D006801:Humans; D020370:Osteoarthritis, Knee / Q000534:rehabilitation*; D059408:Pain Management / Q000379:methods*; D017410:Practice Guidelines as Topic
Therapeutic exercise; aerobic exercises; clinical practice guideline; knee osteoarthritis; systematic review