A Systematic Review of Clinical Practice Guidelines for Physical Therapy Management of Hip and Knee Osteoarthritis

This study evaluated existing clinical practice guidelines (CPGs) for the physical therapy (PT) management of hip osteoarthritis (HOA) or knee osteoarthritis (KOA) and assessed their quality and applicability for integration into practice. A systematic review of clinical practice guidelines A literature search was conducted for PubMed, CINAHL, Cochrane Database of Systematic Reviews, and SPORTDiscus to locate CPGs published through October 25, 2024. Characteristics of the guidelines were extracted, including country of origin, organization, team members, levels of evidence, grading systems, target audience, and PT recommendations. The methodological quality and clinical applicability of each CPG were assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) II and AGREE Recommendation Excellence (REX) tools, respectively. Seven CPGs were included in this review. There was consensus among CPGs in recommending an examination and evaluation consisting of assessing range of motion of the affected joint, balance, and activity tolerance in people with HOA or KOA. The most common intervention across all CPGs included exercise interventions to improve the strength and mobility of the affected extremity. However, there was minimal information and a lack of consensus on the specific types or dosages for these exercises across the CPGs. This review synthesized and elucidated common recommendations for the PT management of HOA or KOA. The recommendations largely provided exercise interventions; however, they lacked consistency on exercise dosages across the CPGs.