Recommendations for the delivery of therapeutic exercise for people with knee and/or hip osteoarthritis. An international consensus study from the OARSI Rehabilitation Discussion Group.
Consensus; Delphi; Exercise; Implementation; Osteoarthritis; Recommendations; Rheumatology; Biomedical Engineering; Orthopedics and Sports Medicine
Abstract :
[en] ("[en] OBJECTIVE: To develop evidence-informed recommendations to support the delivery of best practice therapeutic exercise for people with knee and/or hip osteoarthritis (OA).
DESIGN: A multi-stage, evidence-informed, international multi-disciplinary consensus process that included: 1) a narrative literature review to synthesise existing evidence; 2) generation of evidence-informed proposition statements about delivery of exercise for people with knee and/or hip OA by an international multi-disciplinary expert panel, with statements refined and analysed thematically; 3) an e-Delphi survey with the expert panel to gain consensus on the most important statements; 4) a final round of statement refinement and thematic analysis to group remaining statements into domains.
RESULTS: The expert panel included 318 members (academics, health care professionals and exercise providers, patient representatives) from 43 countries. Final recommendations comprised 54 specific proposition statements across 11 broad domains: 1) use an evidence-based approach; 2) consider exercise in the context of living with OA and pain; 3) undertake a comprehensive baseline assessment with follow-up; 4) set goals; 5) consider the type of exercise; 6) consider the dose of exercise; 7) modify and progress exercise; 8) individualise exercise; 9) optimise the delivery of exercise; 10) focus on exercise adherence; and 11) provide education about OA and the role of exercise.
CONCLUSION: The breadth of issues identified as important by the international diverse expert panel highlights that delivering therapeutic exercise for OA is multi-dimensional and complex.","[en] ","")
Research Center/Unit :
CIRM - Centre Interdisciplinaire de Recherche sur le Médicament - ULiège
Disciplines :
Rheumatology
Author, co-author :
Holden, M A ; Primary Care Centre Versus Arthritis, School of Medicine, David Weatherall Building, Keele University, Staffordshire, ST5 5BG, UK. Electronic address: m.holden@keele.ac.uk
Metcalf, B; Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, University of Melbourne, Australia. Electronic address: b.metcalf@unimelb.edu.au
Lawford, B J ; Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, University of Melbourne, Australia. Electronic address: belinda.lawford@unimelb.edu.au
Hinman, R S ; Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, University of Melbourne, Australia. Electronic address: ranash@unimelb.edu.au
Boyd, M; Patient Representative, Australia
Button, K; School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, UK. Electronic address: buttonk@cardiff.ac.uk
Collins, N J; School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Australia. Electronic address: n.collins1@uq.edu.au
Cottrell, E; Primary Care Centre Versus Arthritis, School of Medicine, David Weatherall Building, Keele University, Staffordshire, ST5 5BG, UK. Electronic address: e.cottrell@keele.ac.uk
Henrotin, Yves ; Université de Liège - ULiège > Département des sciences de la motricité > Pathologie générale et physiopathologie - Techniques particulières de kinésithérapie
Larsen, J B ; Musculoskeletal Health and Implementation, Department of Health Science and Technology, Aalborg University, Denmark. Electronic address: jbl@hst.aau.dk
Master, H; Vanderbilt Institute of Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA. Electronic address: hiral@udel.edu
Skou, S T ; Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark, The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Denmark. Electronic address: stskou@health.sdu.dk
Thoma, L M ; Division of Physical Therapy, Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: louise_thoma@med.unc.edu
Wellsandt, E ; Division of Physical Therapy Education, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA. Electronic address: elizabeth.wellsandt@unmc.edu
White, D K; Department of Physical Therapy, College of Health Sciences, University of Delaware, Newark, DE, USA. Electronic address: dkw@udel.edu
Bennell, K; Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, University of Melbourne, Australia. Electronic address: k.bennell@unimelb.edu.au
Recommendations for the delivery of therapeutic exercise for people with knee and/or hip osteoarthritis. An international consensus study from the OARSI Rehabilitation Discussion Group.
RSH is supported by a National Health and Medical Research Council (NHMRC) Senior Research Fellowship ( #1154217 ). EW is supported by the Rheumatology Research Foundation Investigator Award and National Institutes of Health (NIH) ( R21AR075254 ). STS is funded by a grant from Region Zealand (Exercise First) and two grants from the European Union's Horizon 2020 research and innovation program , one from the European Research Council (MOBILIZE, grant agreement No 801790 ) and the other under grant agreement No 945377 ( ESCAPE ). KLB is supported by a NHMRC Investigator Grant ( #1174431 ). LMT is supported by the NIH ( K23AR079037 ).This project was funded by a NHMRC Investigator grant (#1174431).YH is associate editor of Therapeutic Advance in Musculoskeletal Diseases, has received grants from the Fond National de la Recherche Scientific in Belgium and from Walloon government. He is also the founder and President of The Osteoarthritis Foundation a not-profit association of patient and supporting research initiative. He also received personal fees from industry all of which are out of the scope of this research work.
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