Volume 18, Issue 4 p. 575-595
CLINICAL UPDATE

A clinical practice guideline for physical therapy in patients with hip or knee osteoarthritis

Mitchell C.M. van Doormaal

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 author
Guus A. Meerhoff

Guus 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 author
Thea P.M. Vliet Vlieland

Thea P.M. Vliet Vlieland

Department of Orthopaedics, Leiden University Medical Center (LUMC), Leiden, The Netherlands

Search for more papers by this author
Wilfred F. Peter

Wilfred 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 author
First published: 09 July 2020
Citations: 54

Abstract

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.

The full text of this article hosted at iucr.org is unavailable due to technical difficulties.