Article

OBJECTIVE: To update the Evidence-Based Clinical Practice Guidelines (EBCPGs) on
aerobic walking programs for the management of osteoarthritis (OA) of the knee.
DATA SOURCES: A literature search was conducted using the electronic databases
MEDLINE, PubMed, and the Cochrane Library for all studies related to aerobic
walking programs for OA from 1966 until February 2011. STUDY SELECTION: The
literature search found 719 potential records, and 10 full-text articles were
included according to the selection criteria. The Ottawa Methods Group
established the inclusion and exclusion criteria regarding the characteristics of
the population, by selecting adults of 40 years old and older who were diagnosed
with OA of the knee. DATA EXTRACTION: Two reviewers independently extracted
important information from each selected study using standardized data extraction
forms, such as the interventions, comparisons, outcomes, time period of the
effect measured, and study design. The statistical analysis was reported using
the Cochrane collaboration methods. An improvement of
15% or more relative to a
control group contributes to the achievement of a statistically significant and
clinically relevant progress. A specific grading system for recommendations,
created by the Ottawa Panel, used a level system (level I for randomized
controlled studies and level II for nonrandomized articles). The strength of the
evidence of the recommendations was graded using a system with letters: A, B, C+,
C, D, D+, or D-. DATA SYNTHESIS: Evidence from 7 high-quality studies
demonstrated that facility, hospital, and home-based aerobic walking programs
with other therapies are effective interventions in the shorter term for the
management of patients with OA to improve stiffness, strength, mobility, and
endurance. CONCLUSIONS:
The greatest improvements were found in pain, quality of
life, and functional status (grades A, B, or C+). A common limitation inherent to
the EBCPGs is the heterogeneity of studies included with regards to the
characteristics of the population, the interventions, the comparators, the
outcomes, the period of time, and the study design. It is strongly recommended to
use the Cochrane Risk of Bias Summary assessment to evaluate the methodologic
quality of the studies and to consider avenues for future research on how aerobic
walking programs would be beneficial in the management of OA of the hip.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS