“With the growing international burden of OA, embracing exercise therapy and pro…

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“With the growing international burden of OA, embracing exercise therapy and promoting physical activity as first-line treatments offered to all people with hip and knee OA are essential.”

“Exercise therapy is a safe and effective solution for managing both OA and a range of other chronic conditions that does not require potentially harmful and costly pharmacotherapy, injections, or surgery.”

“Exercise therapy is a specific type of physical activity designed and prescribed for specific therapeutic goals.59 Compelling evidence from more than 50 randomized controlled trials (RCTs) in knee OA33 and 10 RCTs in hip OA34 supports the efficacy of land-based exercise therapy in reducing symptoms and impairments.”

3 or more exercise therapy sessions/week + 1 to 2 further sessions/week of unsupervised home exercise is a good starting point for people with hip and knee OA.

“based on currently accepted exercise prescription recommendations from the American College of Sports Medicine, 2 sessions per week, with 2 to 4 sets of 8 to 12 repetitions at an intensity of 60% to 80% of the individual’s 1-repetition maximum effort in a number of carefully selected exercises, are likely to address strength deficits seen in hip and knee OA.”

“based on the nationwide implementation initiative Good Life with osteoArthritis in Denmark (GLA:D), implementing education and 2 sessions of supervised neuromuscular exercise therapy per week for 6 weeks leads to a significant positive impact on patient symptoms, impairments, consumption of pain medications, and sick leave.”

“Current physical activity guidelines recommend at least 150 minutes of moderate or 75 minutes of vigorous physical activity, in bouts of at least 10 minutes’ duration, per week.”

“the majority of people with hip and knee OA do not meet physical activity guidelines, and are less active than their age-matched counterparts. Importantly, physical inactivity in people with OA also increases their risk of a number of comorbidities and functional decline, leading to higher health care costs.”

“Reduced physical activity levels in people with knee OA may be a key factor driving greater body mass index (BMI) in this group of people.Highlighting a likely vicious cycle, risk of knee OA is also reported to increase exponentially with increasing BMI. Importantly for people with knee OA, a 5% reduction in weight leads to moderate to large improvements in functional impairments, and there is a dose-response relationship between percentage of weight loss and symptomatic improvement… addressing dietary factors is a key component to achieving weight reduction”

“When the potential benefits48 and harms66 are compared, it is difficult to argue against the implementation of physical activity and exercise therapy for people with OA. However, some barriers and potential contraindications do exist. Key barriers to physical activity and exercise therapy in people with OA relate to fear of movement and pain flares. Fear-avoidance beliefs are common in individuals with OA and relate to impaired physical function. A substantial number of people with OA fear that they may injure themselves as a result of physical activity participation. Therefore, assistance in addressing fear of physical activity is essential to addressing physical inactivity and improving long-term adherence to exercise therapy. In most cases, reassurance to patients who may be fearful that exercise therapy can damage their joints should be provided.It is vitally important that patients are well educated about potential pain flares and how to adjust their exercises should pain flares occur”



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