The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part one: introduction, and mind-body exercise programs.
OBJECTIVE
To identify effective mind-body exercise programs and provide clinicians and patients with updated, high-quality recommendations concerning non-traditional land-based exercises for knee osteoarthritis.


METHODS
A systematic search and adapted selection criteria included comparative controlled trials with mind-body 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+, D-) was used, based on statistical significance ( P < 0.5) and clinical importance (⩾15% improvement).


RESULTS
The four high-quality studies identified demonstrated that various mind-body exercise programs are promising for improving the management of knee osteoarthritis. Hatha Yoga demonstrated significant improvement for pain relief (Grade B) and physical function (Grade C+). Tai Chi Qigong demonstrated significant improvement for quality of life (Grade B), pain relief (Grade C+) and physical function (Grade C+). Sun style Tai Chi gave significant improvement for pain relief (Grade B) and physical function (Grade B).


CONCLUSIONS
Mind-body exercises are promising approaches to reduce pain, as well as to improve 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 Mizusaki
AM
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 Álvarez
ICÁ
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 De
G
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
18 Faculty of Health Sciences, Clinical and Rehabilitation Sciences Research Group, University of Sydney, Sydney, Australia.
Alison
A
Harmer
3 School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.
Glen P
GP
Kenny
19 The Arthritis Society, Ottawa Office, Ontario Division, Ottawa, Ontario, Canada.
Gail
G
Paterson
20 Centre de recherche Epidémiologie et Biostatistique, Hôpital Hôtel-Dieu, Paris, France.
Jean-Philippe
JP
Regnaux
21 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; D005081:Exercise Therapy / Q000379:methods / Q000592:standards*; D006801:Humans; D026441:Mind-Body Therapies / Q000379:methods / Q000592:standards*; D053580:Muscle Strength / Q000502:physiology; D020370:Osteoarthritis, Knee / Q000534:rehabilitation*; D059408:Pain Management / Q000379:methods*; D017410:Practice Guidelines as Topic
Therapeutic exercise; clinical practice guideline; knee osteoarthritis; management; mind-body exercises; recommendations; rehabilitation; rheumatology; systematic review