Physiotherapy management of lower limb osteoarthritis

Background: Osteoarthritis (OA) of the lower limb affects millions of people worldwide, and results in pain and reduced function. We reviewed guidelines and Cochrane reviews for physical therapy interventions to manage the condition.

Sources of data: Evidence from meta-analyses and systematic reviews was included. We also identified the recommendations from guidelines relevant to practice in the UK.

Areas of agreement: There is strongest evidence to support the use of exercise to improve pain, function and quality of life.

Areas of controversy: There is limited evidence to support the use of some commonly utilized physiotherapy interventions. National Institute for Health and Clinical Excellence do not recommend the use of acupuncture.

Growing points: Programmes that include single exercise type may be more beneficial than combined strengthening and aerobic interventions.

Areas timely for developing research: Further research is required to determine how to facilitate long-term engagement with exercise to sustain the beneficial effects on pain, function and quality of life. Studies that investigate packages of care, combining interventions require further investigation.