Osteoarthritis Year in Review: Rehabilitation and Outcomes
Monica R. Maly1, Shawn M. Robbins2
1School of Rehabilitation Science, McMaster University and 2School of Physical and Occupational Therapy, McGill University
The purpose of this review was to highlight research studies examining rehabilitation for hip and knee osteoarthritis, as well as the outcomes used to assess treatment effectiveness, published between January and December 2013. A systematic literature search was performed in Medline, CIHAHL and Embase databases from January 1, 2013 to December 12, 2013. Key words used in the searches included osteoarthritis, knee; osteoarthritis, hip; rehabilitation; physical therapy modalities; physical therapy; physiotherapy; and exercise. Publication titles and abstracts were reviewed for inclusion by both authors. Papers were evaluated for quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system by both authors. Of 502 titles reviewed, 36 studies were identified for inclusion. An assessment of the quality of evidence revealed that articles were of high (n=2), moderate (n=14), low (n=10) and very low (n=10) quality. Papers were grouped based on outcome measures: disease/tissue markers, pain, self-reported physical function, mobility performance, general health, and participation/quality of life. Interventions reflected exercise (strengthening, walking, yoga, gaming), physical agents and electrotherapy (ultrasound, phonophoresis, short wave diathermy, transcutaneous electrical nerve stimulation, neuromuscular electrical stimulation), manual therapy (mobilizations, traction), Chinese medicine (acupuncture, meridians) and other (pain coping, counseling, whole body vibration). High quality studies highlighted rehabilitation strategies that improved markers of OA disease and general health, in addition to improvements in clinical outcomes, over both the short term and long term.