A clinical practice guideline for physical therapy in patients with hip or knee osteoarthritis
Corresponding Author
Mitchell C.M. van Doormaal
Royal Dutch Society for Physical Therapy (KNGF), Amersfoort, The Netherlands
Correspondence
Mitchell C. M. van Doormaal, Royal Dutch Society for Physical Therapy (KNGF), Stadsring 159B, Amersfoort 3817 BA, The Netherlands.
Email: m.vandoormaal@kngf.nl
Search for more papers by this authorGuus A. Meerhoff
Royal Dutch Society for Physical Therapy (KNGF), Amersfoort, The Netherlands
Radboud Institute for Health Sciences, IQ healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
Search for more papers by this authorThea P.M. Vliet Vlieland
Department of Orthopaedics, Leiden University Medical Center (LUMC), Leiden, The Netherlands
Search for more papers by this authorWilfred F. Peter
Department of Orthopaedics, Leiden University Medical Center (LUMC), Leiden, The Netherlands
Amsterdam Rehabilitation Research Center, Amsterdam, The Netherlands
Search for more papers by this authorCorresponding Author
Mitchell C.M. van Doormaal
Royal Dutch Society for Physical Therapy (KNGF), Amersfoort, The Netherlands
Correspondence
Mitchell C. M. van Doormaal, Royal Dutch Society for Physical Therapy (KNGF), Stadsring 159B, Amersfoort 3817 BA, The Netherlands.
Email: m.vandoormaal@kngf.nl
Search for more papers by this authorGuus A. Meerhoff
Royal Dutch Society for Physical Therapy (KNGF), Amersfoort, The Netherlands
Radboud Institute for Health Sciences, IQ healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
Search for more papers by this authorThea P.M. Vliet Vlieland
Department of Orthopaedics, Leiden University Medical Center (LUMC), Leiden, The Netherlands
Search for more papers by this authorWilfred F. Peter
Department of Orthopaedics, Leiden University Medical Center (LUMC), Leiden, The Netherlands
Amsterdam Rehabilitation Research Center, Amsterdam, The Netherlands
Search for more papers by this authorAbstract
Objective
The purpose of this paper is to revise the 2010 Dutch guideline for physical therapy (PT) in patients with hip or knee osteoarthritis (OA), issued by the Royal Dutch Society for Physical Therapy (KNGF).
Method
This revised guideline was developed according to the Appraisal of Guidelines for Research and Evaluation (AGREE) and Guidelines International Network (G-I-N) standards. A multidisciplinary guideline panel formulated clinical questions based on perceived barriers to current care. A narrative or systematic literature review was undertaken in response to each clinical question. The panel formulated recommendations based on evidence and additional considerations, as described in the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Evidence-to-Decision framework.
Results
A comprehensive assessment should be based on the International Classification of Functioning Disability and Health (ICF) core set for OA, including the identification of OA-related red flags. Based on the assessment, four treatment profiles were distinguished: (1) education and instructions for unsupervised exercises, (2) education and short-term supervised exercise therapy, (3) education and longer term supervised exercise therapy, and (4) education and exercise therapy before and/or after total hip or knee surgery. Education included individualized information, advice, instructions, and self-management support. Exercise programs were tailored to individual OA-related issues, were adequately dosed, and were in line with public health recommendations for physical activity. Recommended measurement instruments included the Patient-Specific Complaints Instrument, the Numeric Pain Rating Scale, the Hip Disability and Osteoarthritis Outcome Score/the Knee Injury Osteoarthritis Outcome Score, and the Six Minute Walk Test.
Conclusion
An evidence-based PT guideline for the management of patients with hip or knee OA was developed. To improve quality of care for these patients, an extensive implementation strategy is necessary.
CONFLICT OF INTEREST
The authors declare that there is no conflict of interest regarding the publication of this article or the development of the CPG.
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