The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part three: aerobic exercise programs

Clin Rehabil. 2017 May;31(5):612-624. doi: 10.1177/0269215517691085. Epub 2017 Feb 9.


Objectives: To identify effective aerobic exercise programs and provide clinicians and patients with updated, high-quality recommendations concerning traditional land-based exercises for knee osteoarthritis.

Methods: A systematic search and adapted selection criteria included comparative controlled trials with strengthening exercise programs for patients with knee osteoarthritis. A panel of experts reached consensus on the recommendations using a Delphi survey. A hierarchical alphabetical grading system (A, B, C+, C, D, D+, or D-) was used, based on statistical significance ( P < 0.5) and clinical importance (⩾15% improvement).

Results: The five high-quality studies included demonstrated that various aerobic training exercises are generally effective for improving knee osteoarthritis within a 12-week period. An aerobic exercise program demonstrated significant improvement for pain relief (Grade B), physical function (Grade B) and quality of life (Grade C+). Aerobic exercise in combination with strengthening exercises showed significant improvement for pain relief (3 Grade A) and physical function (2 Grade A, 2 Grade B).

Conclusion: A short-term aerobic exercise program with/without muscle strengthening exercises is promising for reducing pain, improving physical function and quality of life for individuals with knee osteoarthritis.

Keywords: Therapeutic exercise; aerobic exercises; clinical practice guideline; knee osteoarthritis; systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Evidence-Based Medicine*
  • Exercise / physiology*
  • Exercise Therapy / methods
  • Exercise Therapy / standards*
  • Humans
  • Osteoarthritis, Knee / rehabilitation*
  • Pain Management / methods*
  • Practice Guidelines as Topic