The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part one: Introduction, and mind-body exercise programs


Author: Brosseau L1, Taki J2, Desjardins B3, Thevenot O3, Fransen M4, Wells GA5, Imoto AM6, Toupin-April K7, Westby M8, Gallardo IC9, Gifford W10, Laferrière L11, Rahman P12, Loew L13, Angelis G13, Cavallo S13, Shallwani SM13, Aburub A13, Bennell KL14, Van der Esch M15, Simic M16, McConnell S17, Harmer A18, Kenny GP3, Paterson G19, Regnaux JP20, Lefevre-Colau MM21, McLean L1

Affiliation: <sup>1</sup>1 Physiotherapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.

<sup>2</sup>2 Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.

<sup>3</sup>3 School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.

<sup>4</sup>4 Faculty of Health Sciences, University of Sydney, Sydney, Australia.

<sup>5</sup>5 School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada.

<sup>6</sup>6 UNIFESP, Internal Medicine, Brasilia, Brazil.

<sup>7</sup>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.

<sup>8</sup>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.

<sup>9</sup>9 Department of Physical Education and Sport, University of Granada, Granada, Spain.

<sup>10</sup>10 School of Nursing, University of Ottawa, Ottawa, Ontario, Canada.

<sup>11</sup>11 Canadian Forces Health Services Group Headquarters, National Defense, Ottawa, Ontario, Canada.

<sup>12</sup>12 Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.

<sup>13</sup>13 School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.

<sup>14</sup>14 Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia.

<sup>15</sup>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.

<sup>16</sup>16 Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia.

<sup>17</sup>17 Department of Medicine, St. Joseph's Health Care Centre, Toronto, Ontario, Canada.

<sup>18</sup>18 Faculty of Health Sciences, Clinical and Rehabilitation Sciences Research Group, University of Sydney, Sydney, Australia.

<sup>19</sup>19 The Arthritis Society, Ottawa Office, Ontario Division, Ottawa, Ontario, Canada.

<sup>20</sup>20 Centre de recherche Epidémiologie et Biostatistique, Hôpital Hôtel-Dieu, Paris, France.

<sup>21</sup>21 Institute of Rheumatology, Department of Medicine and Rehabilitation, Cochin Hospital, Paris, France.
Conference/Journal: Clin Rehabil.
Date published: 2017 Jan 1
Other:
 Volume ID: 269215517691083   ,  Special Notes: doi: 10.1177/0269215517691083. [Epub ahead of print]   ,  Word Count: 198  
    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).



CONCLUSION: 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.



KEYWORDS: Therapeutic exercise; clinical practice guideline; knee osteoarthritis; management; mind-body exercises; recommendations; rehabilitation; rheumatology; systematic review



PMID: 28183188  DOI: 10.1177/0269215517691083