Abstract
Objective
To undertake a systematic critical appraisal of guidelines to provide a summary of
recommendations for the physical management of osteoarthritis (OA).
Data Sources
The Cochrane Library, MEDLINE, CINAHL, SPORTDiscus with Full Text, Scopus, ScienceDirect,
PEDro, and Google Scholar databases were searched (2000–2013) to identify all guidelines,
protocols, and recommendations for the management or treatment of OA. In addition,
Internet searches of all relevant arthritis organizations were undertaken. All searches
were performed between July 2012 and end of April 2013. Guidelines that included only
pharmacological, injection therapy, or surgical interventions were excluded. Guidelines
published only in English were retrieved.
Study Selection
OA guidelines developed from evidence-based research, consensus, and/or expert opinion
were retrieved. There were no restrictions on severity or site of OA, sex, or age.
Nineteen guidelines were identified for evaluation.
Data Extraction
The quality of all guidelines was critically appraised using the Appraisal of Guidelines
for REsearch and Evaluation II instrument. Each guideline was independently reviewed.
All relevant recommendations for the physical management of OA were synthesized, graded,
and ranked according to available evidence.
Data Synthesis
Seventeen guidelines with recommendations on the physical management of OA met the
inclusion criteria and underwent a full critical appraisal. There were variations
in the interventions, levels of evidence, and strength of recommendations across the
guidelines. Forty different interventions were identified. Recommendations were graded
from “strongly recommended” to “unsupported.” Exercise and education were found to
be strongly recommended by most guidelines.
Conclusions
Exercise and education were key recommendations supporting the importance of rehabilitation
in the physical management of OA. This critical appraisal can assist health care providers
who are involved in the management of people with OA.
Keywords
List of abbreviations:
AGREE II (Appraisal of Guidelines for REsearch and Evaluation II), LOE (level of evidence), MA (meta-analysis), NICE (National Institute of Clinical Excellence), OA (osteoarthritis), RCT (randomized controlled trial), SOR (strength of recommendation)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 04, 2013
Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
