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Vol. 27. Issue 4.
(01 July 2023)
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Vol. 27. Issue 4.
(01 July 2023)
Systematic Review
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What are the unsupervised exercise adherence rates in clinical trials for knee osteoarthritis? A systematic review
Kristin M. Smitha,
Corresponding author

Corresponding author at: 111 Raley Blvd Ste 140, Chico, CA 95928, USA.
, B. James Masseya,b, Jodi L. Younga, Daniel I. Rhona,c
a Science Program in Physical Therapy, Bellin College, Green Bay, WI, USA
b Department of Physical Therapy, Wingate University, Wingate, NC, USA
c Department of Rehabilitation Medicine, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA

  • Exercise trials for knee osteoarthritis are not consistently collecting and reporting information about exercise adherence.

  • Without information about adherence, the understanding of true treatment effect sizes of exercise for individuals with knee osteoarthritis is limited.

  • Only 10.2% of trials provided a predetermined threshold of adequate adherence, and outcomes did not appear to differ in those who met the threshold. However, metrics, thresholds, and comparator groups were highly heterogeneous in these trials, limiting any conclusions.

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Tables (3)
Table 1. Pooled descriptive data across studies that collected and reported adherence data (n = 72 studies).
Table 2. Methods for reporting adherence to unsupervised home exercise programs.
Table 3. Details of studies reporting predetermined thresholds of acceptable adherence.
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Additional material (1)

Exercise is an effective intervention for knee osteoarthritis (OA), and unsupervised exercise programs should be a common adjunct to most treatments. However, it is unknown if current clinical trials are capturing information regarding adherence.


To summarize the extent and quality of reporting of unsupervised exercise adherence in clinical trials for knee OA.


Reviewers searched five databases (PubMed, CINAHL, Medline (OVID), EMBASE and Cochrane). Randomized controlled trials where participants with knee OA engaged in an unsupervised exercise program were included. The extent to which exercise adherence was monitored and reported was assessed and findings were subgrouped according to method for tracking adherence. The types of adherence measurement categories were synthesized. A quality assessment was completed using the Physiotherapy Evidence Database (PEDro) scores.


Of 3622 abstracts screened, 176 studies met criteria for inclusion. PEDro scores for study quality ranged from two to ten (mean=6.3). Exercise adherence data was reported in 72 (40.9%) studies. Twenty-six (14.8%) studies only mentioned collection of adherence. Adherence rates ranged from 3.7 to 100% in trials that reported adherence. For 18 studies (10.2%) that tracked acceptable adherence, there was no clear superiority in treatment effect based on adherence rates.


Clinical trials for knee OA do not consistently collect or report adherence with unsupervised exercise programs. Slightly more than half of the studies reported collecting adherence data while only 40.9% reported findings with substantial heterogeneity in tracking methodology. The clinical relevance of these programs cannot be properly contextualized without this information.

Exercise therapy
Home exercise
Knee osteoarthritis
Unsupervised exercise
Full Text

Knee osteoarthritis (OA) is a common condition responsible for high healthcare use and expenditures. Upwards of 8.6% of lifetime medical costs can be attributed to knee OA ($19,600 ± 16,200 in 2013 US dollars).1 Another average of $7104 (in 2007 US dollars) are lost in work productivity by employed individuals undergoing total knee arthroplasty.2 Clinical guidelines recommend exercise as a core treatment intervention, emphasizing the importance of exercise prescription and use of strength training in both land and water-based settings as appropriate.3-7 In a survey of 1064 Australian physical therapists, 99% of respondents reported the provision of strengthening exercises when serving patients with knee OA.8 A recent meta-analysis concluded that no new research on the benefits of exercise for knee OA is needed due to the robustness of the current body of literature establishing its effectiveness in pain reduction and increase in function.9

Exercise is a common intervention in clinical trials for knee OA, used in both supervised and unsupervised formats.3–5 Adherence is commonly described in the medical literature as a proactive behavior such as completing unsupervised exercise; this differs from compliance which is considered a more passive behavior.10 Adherence plays an important role in the effectiveness of exercise.11 One study of overweight patients with knee OA found that increased exercise adherence was associated with improved walking distance and disability levels.12 Because adherence could influence treatment effect, it is important to understand how adherence is measured in trials that prescribe unsupervised exercise programs. These rates have been studied for other diagnoses. A recent systematic review of rotator cuff related shoulder pain found adherence rates to unsupervised exercise to be between 20 and 100%.13 When adherence to exercise programs designed to reduce falls was greater than 80%, the association with risk reduction for falls was highest.14 There are published adherence rates for combined unsupervised and supervised exercise in individuals with spondyloarthritis (51–95%) and advanced cancer (44–95%), as well as those awaiting organ transplants (82.5–100%).15–17 Additionally, the known adherence rates for individuals with intermittent claudication for walking is 77.6% and “alternative” exercise is 85.8%.18 Each of these studies used the term adherence, but included both unsupervised and supervised exercise.14–18 However, these rates are unknown in patients with knee OA, where exercise is a recommended core treatment that should be used often.3–5

Currently no consensus exists on optimal or standardized methods for reporting exercise adherence in clinical trials. There is substantial variation in the manner in which adherence to exercise interventions is identified, reported, and measured in clinical research.10,19 In a systematic review that investigated measures of adherence to unsupervised exercise programs among populations with “long term physical conditions,” 61 different measures of adherence within 58 studies were identified,10 but the majority did not have established reliability or validity.10 Bailey and colleagues assessed variation in measurement and definition of exercise adherence among studies investigating the effects of exercise on musculoskeletal pain, and only 49% of the 86 included studies provided parameters for determining satisfactory adherence to exercise interventions.20

No studies have looked at the influence of adherence on exercise therapy treatment effect. Adherence rates and methods for tracking adherence are unknown in the knee OA population. Without known adherence rates, decision making is limited in its ability to generalize the information from the studies about exercise choice and dosing. Hence, the purpose of this review was to determine the impact of unsupervised exercise program adherence on exercise therapy treatment effect, as well as determine how adherence is tracked and reported in exercise trials for knee OA.

MethodsInformation sources

In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA),21 this systematic review investigated clinical trials that included exercise programs for the management of individuals with knee OA as identified through database searches in PubMed, CINAHL, Medline (OVID), EMBASE and Cochrane, as well as reference lists from studies meeting the inclusion criteria, with publication dates of 1 January 2002 through 31 December 2021. The protocol was registered (PROSPERO CRD42020187787).

Unsupervised exercise was defined as dosed therapeutic exercise that is completed without the direct observation of a healthcare provider, researcher, or fitness instructor.22,23 It is often referred to as home exercise program or home-based exercise. Supervised exercise is defined as dosed therapeutic exercise that is completed with the direct observation of a healthcare provider, researcher, or fitness instructor.22,24,25 Operationally, we included both facility-based visits and telehealth visits that included video and audio.

Eligibility criteria

Randomized clinical trials were included if they consisted of adults 18 years or older with a diagnosis of knee OA where the primary intervention was supervised exercise therapy that also included a structured unsupervised exercise program (not simply instructions to exercise more or be physically active). Studies were excluded if they were not written or translated in English or included participants with a history of knee arthroplasty because surgery may influence exercise application (i.e., excluded revision surgeries).

Search strategy

Searches included MeSH terms and keywords related to the knee using the Boolean operator “OR” including, but not limited to, variations of the terms tibiofemoral or patellofemoral. These were combined using the Boolean operator “AND” with MeSH terms and keywords for OA variations. Lastly, we combined these using “AND” with keywords related to physical therapy or MeSH terms and keywords for exercise (including specific types of exercise such as walking, stretching, or tai chi). Supplementary Material A provides detailed search strategies.

The searches and full-text studies were organized within Covidence (Veritas Health Innovation, Melbourne, Australia,, a review management software, where all study screening, data extraction and risk of bias assessments were conducted.

Selection and data collection process

Titles and abstracts and full-text studies were screened by two reviewers (KS and BM), with discrepancies resolved through consensus. If no consensus could be reached, a third reviewer would arbitrate (JY). Data were extracted from the final full text studies by one reviewer (KS or BM) and the other confirmed accuracy (unblinded).

Data items

The following data elements were extracted: the presence of unsupervised exercise adherence reports and the method for monitoring adherence. While adherence and compliance have different operational definitions, they are used interchangeably in research reports, and trials using either term were included as long as the intent of tracking fidelity of the unsupervised exercise program was present. For the intent of this review, adherence was defined as “the degree behavior corresponds with an agreed on recommendation.”10 Compliance was defined as yielding to or obeying clinician instructions.26 These usually occur on a spectrum or scale and are rarely dichotomous endstates. See Supplementary Material B for all operational definitions.

Study risk of bias and reporting bias assessment

Methodological quality and bias was extracted from the Physiotherapy Evidence Database (PEDro). For 21 studies, there was no score in the PEDro database and were therefore scored by the reviewers (KS and BM) with consensus reached for all 21 studies (no third reviewer required).27–47 The PEDro scale is considered a valid and reliable measure of bias.48 PEDro scoring includes 11 criteria regarding eligibility, randomization, blinding, baseline statistics, outcome data, missing values and intention to treat, between-group comparisons, and reporting of statistical data. The first item is not used as part of the final scoring because it does not affect internal validity; therefore, the final score is between 0 and 10. A score of five or greater is considered adequate quality.49

Synthesis methods

A synthesis of adherence tracking approaches was conducted. Extracted data were sub-grouped both by collection method and reporting properties. Based on similar systematic reviews, six broad categories of tools for tracking adherence were created and included: single-item self-report questionnaires, multi-item self-report questionnaires, home (unsupervised) exercise diaries, accelerometer-based direct monitoring devices including fitness watches, app/computer-assisted, and researcher check-in.10,19,50 Single-item self-report questionnaires consist of a single question that allows subjects to qualify adherence to exercise parameters for the particular study, whereas multi-item self-report questionnaires accomplish this with the inclusion of more than one question.10,19,50 Multi-item questionnaires were uniquely generated for a particular study or used previously established measures.10,19,50 Generally, home (unsupervised) exercise diaries track adherence with the use of ongoing record keeping of exercise performance throughout the course of a study.10,19,50 Accelerometer-based direct monitoring devices track and record a subject's physical activity with the use of electronic devices that are sensitive to positional change in space. App/computer-assisted measures are electronic interfaces that promote adherence with the use of electronic reminders and adherence reporting. Researcher check-in utilizes ongoing monitoring of adherence through verbal or written report by the subjects at predetermined intervals.

As data were extracted, it became apparent that, in addition to different methods for tracking adherence, studies could also be grouped by the various methods for reporting adherence. These included categories such as percentage of exercises completed (mean by group) and percentage of individuals meeting a threshold predetermined by the researchers (repetitions per day, days exercised per week etc.). Observed commonalities allowed for eight different categories of methods for reporting adherence.

Effect measures

If the data could be homogenized adequately, a meta-analysis was planned to assess the influence of unsupervised exercise program adherence on exercise therapy treatment effect.

Certainty assessment

Certainty assessments were not conducted because the heterogeneity and lack of adherence reporting did not allow for effect estimates.


From 3622 abstracts screened once duplicates were removed, 442 full-texts were reviewed, and 176 met the final eligibility criteria (Fig. 1). Mean PEDro scores are reported in Table 1. Individual item and total PEDro score are presented for each study in Supplementary Material C. The mean and median PEDro score for all studies was 6.3 and 7 respectively, with scores ranging from 2 to 9.

Fig. 1.

Search History.

Table 1.

Pooled descriptive data across studies that collected and reported adherence data (n = 72 studies).

Descriptive data  Pooled results 
Total number of participants(mean per study)  9492 (132) 
Pooled mean age of participants [range]  64.0 [38.8–75.3] 
Pooled mean proportion of participants by sex  Male: 30.6%Female: 69.4% 
Pooled mean duration of studies [range]  33.5 weeks [4 weeks - 128 weeks] 
Pooled mean PEDro scale score [range]  6.7 [2–9] 
Pooled mean adherence rate [range]  67.9% [3.7% - 100%] 

The mean exercise adherence rate was 67.9% and ranged from 3.7% to 100% but was only reported in 72 (40.9%) of the trials. Another 26 (14.8%) trials reported that they collected adherence data but did not report any values. Specific adherence rates for each study are shown in Supplementary Material D.

Measures of adherence were highly variable across studies. Forty-three (43.9%)22,35,42,51–90 studies used an unsupervised exercise diary, 23 (23.5%)38,46,91–111 used multiple collection methods, 12 (12.2%)29,112–122 used researcher check-in, 6 (6.1%)40,123–127 used a single-item questionnaire, 5 (5.1%)128–132 used a multi-item questionnaire, and 2 (2.0%)133 used an accelerometer or fitness watch. Another 7 (7.1%)134–140 studies used a method that did not fit into these categories or the collection method was unclear. All but one of the studies that used multiple collection methods used at minimum an unsupervised exercise diary as one of the methods.38,46,91–96,98–111 The most common combination of methods used in 13 studies (13.3%) was both an unsupervised exercise diary and researcher check-in.38,46,99–101,103–107,109–111 Pedometers were used by 3 (3.1%) studies that used multiple collection methods and 1 (1.0%) study as the sole collection method.108,111,139 Refer to Table 2 for a listing of studies by method of collecting data.

Table 2.

Methods for reporting adherence to unsupervised home exercise programs.

Method  Number of studies (% of 98 studies that collected adherence data) 
Percentage of prescribed exercises completed - mean for group(s)  24 (24.5%)42,52–57,64,66,69,70,75,76,87,92–94,96,103,107,117,118,124,137,141 
Percentage of prescribed exercises completed - median for group(s)  1 (1.0%)82 
Percentage of individuals meeting thresholds of acceptable adherence predetermined by researchers (reps/day and days exercised/ week, daily steps, etc.)  18 (18.4%)46,51,58,62,63,68,77,79,81,85,101,102,108,109,122,134,138,152 
Likert or numeric rating scales  10 (10.2%)40,78,95,97,123,125,127,130–132 
Unique methods  9 (9.2%)59,83,105,119,126,129,133,135,140 
Percentage value without description of how value was calculated  4 (4.1%)72,80,86,113 
Percentage of individuals who completed all exercises  4 (4.1%)61,98,120,136 
Percentage of individuals crudely qualified into categories (e.g. good, moderate, etc.)  2 (2.0%)88,114 
No reporting method but indicated that collected adherence  26 (26.5%)22,29,35,38,60,65,67,71,73,74,84,89–91,99,100,104,106,110–112,115,116,121,128,139 

Methods for monitoring and reporting unsupervised exercise adherence were grouped into eight categories determined by reporting properties. The most commonly used reporting method was the mean percentage of prescribed exercises completed by each group (n = 24, 33.3% of reporting studies).42,52–57,64,66,69,70,75,76,87,92–94,96,103,107,117,118,124,137,141 Other reporting methods included Likert scales or percentage of individuals who completed all exercises. Nine (12.5% of reporting studies) studies were included in a “unique” category because only one study used each method.59,83,105,119,126,129,133,135,140 One study used both adherence to home exercise three times weekly using a numeric-rating scale and Exercise Adherence Rating Scale (EARS) Section B.129 Park et al.119 used the number of subjects who did regular practice at home. In another study, authors reported the number of days exercised per week (mean for group(s)).105 Chaipinyo et al.59 reported the total number of days exercised as a reporting method. Farr et al.133 reported the percentage of physical activity increased per accelerometry data. Foster et al.126 reported the number of individuals who responded according to each value of Likert scale. Knoop et al.135 reported the percentage of subjects who exercised without further specification of any additional adherence parameters. Mikesky et al.140 reported group average for number of weeks participants completed a predetermined threshold, and volume of lower extremity exercises per week (Fig. 2) Because such few studies reported adherence and the few that did had wide heterogeneity in their methods for assessing adherence, a meta-analysis for treatment effect was not possible.

Fig. 2.

Method for collecting adherence data from studies that collected data.


A predetermined threshold for adequate adherence was reported in 18 trials (10.2%). In five of the trials the threshold definition was unspecified, 2 were unclear, five others were based on a percent completion, and the rest met a minimum threshold of exercise (Table 3).

Table 3.

Details of studies reporting predetermined thresholds of acceptable adherence.

Study  Met-predetermined measure of adequate adherence (Rate -%)*  Positive outcome favoring exercise therapy with respect to comparator  Description of adequate adherence rate 
1. Abbott et al. 201351  42.8  Yes  Unspecified 
2. Brosseau et al. 201258  80.2, 65.2  Both groups had exercise; No difference in primary outcomes between groups.  Unspecified 
3. Christensen et al. 201562  3.7  No  Unspecified 
4. Crossley et al. 201563  77  Yes  Unspecified 
5. de Rooij et al. 2017134  86  Yes  Completed ⅔ of exercise sessions 
6. Fitzgerald et al. 2011101  52, 47  Both groups had exercise; no difference in primary outcomes between groups  Completed >80% of sessions 
7. Hinman et al. 200768  84  Yes  Unclear -% of participants who completed unsupervised exercised in any amount 
8. Kloek et al. 2018152  81.1  Both groups had exercise; no difference in primary outcomes between groups  Completed ⅔ of modules 
9. Liao et al. 202146  82.6, 84.3  Both groups had exercise; group with higher adherence rate had better primary outcomes.  Used indicated color band for at least 1 session 
10. Loew et al. 2017102  62, 35.44, 38.44, 56.1, 43.1, 37.9, 76.4, 54.9, 43.4  All groups had exercise; adherence was the primary outcome measure. Preference for exercise appears to affect adherence.  Completed >66% of sessions 
11. Osteras et al. 201977  67, 45  Both groups had exercise; group with higher adherence rate had better primary outcomes.  Had specific exercise for intervention but measured adherence as those who met physical activity guidelines over trial period 
12. Rattanachaiyanont and Kuptniratsaikul 200879  57.4, 22  Both groups had exercise; no difference in outcomes between groups  At least 50 repetitions per day for at least 5 days per week 
13. Schlenk et al. 202181  77.4, 81.1  Yes  Completed >75% of exercises 
14. Sharma M, Singh A, Dhillon MS, Kaur S 2018122  60  Both groups had exercise; no difference in outcomes between groups  Unclear - “Completed exercises correctly” 
15. Stensrud et al. 201585  62.2  Yes  unspecified 
16. Talbot et al. 2003108  56, 35  Yes  Met-or exceed weekly step goal 
17. Wallis et al. 2017109  70  No  Completed 70 +/- 10 min of weekly exercise 
18. Xiao et al. 2021138  70.59, 35  Yes  Completing exercises 3 times per week for one group; “continuing to walk” for comparator 

The multiple percentages per study are data points for different groups OR different time periods.

Only tracked adherence in the intervention group.

Only reported one value across both groups.


Of 98 trials (55.7% of all studies) making a claim that adherence was measured, actual rates were reported in only 72 trials (40.9%). The mean adherence rate was 67.9% across these trials (range from 3.7% to 100%). Only 18 trials (10.2%) reported a predetermined threshold of acceptable adherence and based on these studies, there was no clear indication that adherence improved outcomes, although large heterogeneity in methodology limits any conclusions. The most commonly used tools to measure adherence were exercise diaries followed by researcher check-in. Multiple methods were used in 23 studies, in which authors used a combination of assessments. There was also high variability in the approaches taken to report adherence across studies, with eight distinct categories identified. It is notable that although we grouped adherence into eight categories based on similar characteristics, there was further variability within some of those categories. For example, there was wide variation among studies as to what researchers considered to represent being adherent. Overall, poorly measured adherence and/or reported adherence further confounds our understanding of treatment effects for exercise interventions for knee OA.

Comparison to recent literature

A recent systematic review studied adherence to many types of knee OA interventions and found that treatment frequency was the most commonly reported measure but few studies quantified what an acceptable frequency was (i.e. level of adherence).142 In 2017, a systematic review reporting on adherence measures for unsupervised exercise programs used with musculoskeletal disorders found that out of 234 ways to measure exercise adherence, only 49 were reproducible and only seven had any validity and reliability metrics to support them.143 All seven of these were multi-item questionnaires, but only one, the Community Health Activities Model Program for Seniors (CHAMPS), has been validated and even this was of questionable quality for research purposes.144 A more recent tool that has been validated in patients with chronic low back pain and appears to be useful for both clinical and research is the EARS.145 This is also currently being studied in patients with knee OA.146 In our review, only three studies used these validated tools (one used CHAMPS; two used EARS).95,128,129

Data collection methods for adherence

The majority of studies that collected adherence data (n = 56; 57.1%) used self-reported exercise diaries, either alone or in combination with other collection methods. This is consistent with the findings by Duong et al.142 where 66.4% of studies used an unsupervised exercise diary. We found high variability for when and how these were filled out by patients. Some studies expected the exercise diary to be completed daily and others weekly.54,147 There was also variance in what variables were logged, such as simply whether a session was done or if more complex details were required, including reporting the number of minutes completed or exact number of repetitions.56,57,79 There were also many different strategies that researchers used to calculate percentage values representing adherence across studies. While this may appear to be the most feasible strategy, there does not appear to be extensive research on the validity and reliability of exercise diaries for this purpose. Findings from a cohort study not in this review simultaneously using accelerometers and exercise diaries found that self-reported exercise adherence over a 12-week period was overestimated in the diary and had only a moderate correlation with accelerometer data.148 One study in our review used both exercise diaries and an accelerometer but did not correlate the data between the two methods.94 Another study concluded that the design of the diary likely does not matter, but that individualized data from the diaries were highly variable and lacked validity.149 However, in another systematic review on the use of home-based rehabilitation interventions, the conclusion was that exercise diaries may be valid in certain populations.150 Therefore, due to conflicting conclusions, the adherence rates from exercise diaries may not be useful.

Clinical implications

What is known about the efficacy of exercise interventions for people with knee OA could be adversely affected by the limited number of studies that collect and report exercise adherence data. Reporting of exercise dosing in this population is not held to the standards applied in drug trials.151 Almost half of the studies (n = 78; 44.3%) did not monitor exercise adherence, limiting conclusions that can be made about its efficacy. Based on this information, it is difficult to fully understand exercise treatment effects reported in trials and make recommendations for exercise prescription in clinical care. While an individual patient data (IPD) meta-analysis could potentially show greater promise for answering this research question, it would likely still be of limited value until adherence measures are better harmonized and reported across exercise trials for knee OA.

This review highlights a critical research gap: the lack of standardization with collecting and reporting of exercise adherence and the consideration of adherence when analyzing treatment effect in exercise therapy trials. The inability to establish superiority between different types of exercise for knee OA could be influenced by a poor understanding of adherence rates.23 Further research to define optimal method(s) for collecting and reporting exercise adherence is an important need. These data are necessary to understand how adherence rates influence treatment effects for knee OA trials. Until this research is completed, researchers are most likely best served by using multiple methods for collection of data adherence including a home diary, a multi-item questionnaire (possibly the EARS), and an accelerometer.


There are some limitations to discuss. Diagnostic criteria for knee OA could not be verified or validated, and therefore assessing heterogeneity and phenotypes of participants across the disease spectrum was not possible (e.g., low versus high severity). Exercise may have been used but was not the primary intervention in some trials, and therefore was missed by our search terms. Also, several studies in this review assessed “adherence” to the entire intervention, of which unsupervised exercise was only one part. Poor adherence in these cases might not have been specific to the exercise components.


Data regarding adherence to unsupervised exercise programs are not consistently collected (or reported) among studies investigating exercise interventions for knee OA. Approximately half of the studies (n = 98; 55.7%) claimed to collect these data, but there was no consistent method for collecting or reporting across studies. Clinical trials should adequately collect and report adherence to unsupervised exercise, as this factor is essential to developing a better understanding of treatment effect. A more consistent and validated approach would improve the ability to compare results across trials.


The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of Brooke Army Medical Center, the U.S. Army Medical Department, the Department of the Army, the Uniformed Services University of the Health Sciences, the Defense Health Agency, the Department of Defense, or the U.S. Government.

E. Losina, A.M. Weinstein, W.M. Reichmann, et al.
Lifetime risk and age at diagnosis of symptomatic knee osteoarthritis in the US.
Arthritis Care Res, 65 (2013), pp. 703-711
E. Losina, A.D. Paltiel, A.M. Weinstein, et al.
Lifetime medical costs of knee osteoarthritis management in the United States: impact of extending indications for total knee arthroplasty.
Arthritis Care Res, 67 (2015), pp. 203-215
T.E. McAlindon, R.R. Bannuru, M.C. Sullivan, et al.
OARSI guidelines for the non-surgical management of knee osteoarthritis.
Osteoarthritis Cartilage, 22 (2014), pp. 363-388
S.L. Kolasinski, T. Neogi, M.C. Hochberg, et al.
2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee.
Arthritis Care Res, 72 (2020), pp. 149-162
L. Fernandes, K.B. Hagen, J.W.J. Bijlsma, et al.
EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis.
Ann Rheum Dis, 72 (2013), pp. 1125-1135
M. Hurley, K. Dickson, R. Hallett, et al.
Exercise interventions and patient beliefs for people with hip, knee or hip and knee osteoarthritis: a mixed methods review.
Cochrane Database Syst Rev, 4 (2018),
L.O. Dantas, F. Salvini T de, T.E. McAlindon.
Knee osteoarthritis: key treatments and implications for physical therapy.
Braz J Phys Ther, 25 (2021), pp. 135-146
C.J. Barton, M.F. Pazzinatto, K.M. Crossley, et al.
Reported practices related to, and capability to provide, first-line knee osteoarthritis treatments: a survey of 1064 Australian physical therapists.
Braz J Phys Ther, 25 (2021), pp. 854-863
A.P. Verhagen, M. Ferreira, E.A.E. Reijneveld-van de Vendel, et al.
Do we need another trial on exercise in patients with knee osteoarthritis?: no new trials on exercise in knee OA.
Osteoarthritis Cartilage, 27 (2019), pp. 1266-1269
J.C. Bollen, S.G. Dean, R.J. Siegert, T.E. Howe, V.A. Goodwin.
A systematic review of measures of self-reported adherence to unsupervised home-based rehabilitation exercise programmes, and their psychometric properties.
BMJ Open, 4 (2014),
M. Friedrich, G. Gittler, M. Arendasy, K.M. Friedrich.
Long-term effect of a combined exercise and motivational program on the level of disability of patients with chronic low back pain.
C.H. van Gool, B.W.J.H. Penninx, G.I.J.M. Kempen, et al.
Effects of exercise adherence on physical function among overweight older adults with knee osteoarthritis.
Arthritis Rheum, 53 (2005), pp. 24-32
K. Hall, A. Grinstead, J.S. Lewis, C. Mercer, A. Moore, C. Ridehalgh.
Rotator cuff related shoulder pain. Describing home exercise adherence and the use of behavior change interventions to promote home exercise adherence: a systematic review of randomized controlled trials.
Phys Ther Rev, 26 (2021), pp. 299-322
O. Osho, O. Owoeye, S. Armijo-Olivo.
Adherence and attrition in fall prevention exercise programs for community-dwelling older adults: a systematic review and meta-analysis.
J Aging Phys Act, 26 (2018), pp. 304-326
M.T. McDonald, S. Siebert, E.H. Coulter, D.A. McDonald, L. Paul.
Level of adherence to prescribed exercise in spondyloarthritis and factors affecting this adherence: a systematic review.
Rheumatol Int, 39 (2019), pp. 187-201
M.P. Wallen, T.L. Skinner, T.G. Pavey, A. Hall, G.A. Macdonald, J.S. Coombes.
Safety, adherence and efficacy of exercise training in solid-organ transplant candidates: a systematic review.
Transplant Rev, 30 (2016), pp. 218-226
G. Sheill, E. Guinan, L. Brady, D. Hevey, J. Hussey.
Exercise interventions for patients with advanced cancer: a systematic review of recruitment, attrition, and exercise adherence rates.
Palliat Support Care, 17 (2019), pp. 686-696
E. Lin, C.H. Nguyen, S.G. Thomas.
Completion and adherence rates to exercise interventions in intermittent claudication: traditional exercise versus alternative exercise - a systematic review.
Eur J Prev Cardiol, 26 (2019), pp. 1625-1633
A.M. Hall, S.J. Kamper, M. Hernon, et al.
Measurement tools for adherence to non-pharmacologic self-management treatment for chronic musculoskeletal conditions: a systematic review.
Arch Phys Med Rehabil, 96 (2015), pp. 552-562
D.L. Bailey, M.A. Holden, N.E. Foster, J.G. Quicke, K.L. Haywood, A. Bishop.
Defining adherence to therapeutic exercise for musculoskeletal pain: a systematic review.
Br J Sports Med, 54 (2020), pp. 326-331
D. Moher, A. Liberati, J. Tetzlaff, D.G. Altman, PRISMA Group.
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.
Ann Intern Med, 151 (2009), pp. 264-269
G.D. Deyle, S.C. Allison, R.L. Matekel, et al.
Physical therapy treatment effectiveness for osteoarthritis of the knee: a randomized comparison of supervised clinical exercise and manual therapy procedures versus a home exercise program.
Phys Ther, 85 (2005), pp. 1301-1317
M. Fransen, S. McConnell, A.R. Harmer, M. Van der Esch, M. Simic, K.L. Bennell.
Exercise for osteoarthritis of the knee.
Cochrane Database Syst Rev, 1 (2015),
N. Piyakhachornrot, S. Aree-Ue, P. Putwatana, V. Kawinwonggowit.
Impact of an integrated health education and exercise program in middle-aged Thai adults with osteoarthritis of the knee.
Orthop Nurs, 30 (2011), pp. 134-142
T. Magrans-Courtney, C. Wilborn, C. Rasmussen, et al.
Effects of diet type and supplementation of glucosamine, chondroitin, and MSM on body composition, functional status, and markers of health in women with knee osteoarthritis initiating a resistance-based exercise and weight loss program.
J Int Soc Sports Nutr, 8 (2011), pp. 8
K.E. Lutfey, W.J. Wishner.
Beyond“ compliance” is“ adherence”. Improving the prospect of diabetes care.
Diabetes Care, 22 (1999), pp. 635-639
X. Bao, J.W. Tan, M. Flyzik, X.C. Ma, H. Liu, H.Y. Liu.
Effect of therapeutic exercise on knee osteoarthritis after intra-articular injection of botulinum toxin type A, hyaluronate or saline: a randomized controlled trial.
J Rehabil Med, 50 (2018), pp. 534-541
M. Bayramoğlu, M. Karataş, N. Cetin, N. Akman, S. Sözay, A. Dilek.
Comparison of two different viscosupplements in knee osteoarthritis–a pilot study.
Clin Rheumatol, 22 (2003), pp. 118-122
U. Dincer, S. Aribal, H. Saygin, M. Incedayi, O. Rodop.
The effects of closed kinetic chain exercise on articular cartilage morphology: myth or reality? A randomized controlled clinical trial.
Türkiye Fiziksel Tip ve Rehabilitasyon Dergisi, (2016),
B. Erhan, B. GÜndÜz, S.H. ÜstÜnel, et al.
The efficacy of topical glucosamine sulfate-chondroitin sulfate in knee osteoarthritis treated with physical therapy: a randomized, double-blind, placebo-controlled study.
Turkish J Phys Med Rehab/Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi, 58 (2012),
G. Gondhalekar, M. Deo.
Retrowalking as an adjunct to conventional treatment versus conventional treatment alone on pain and disability in patients with acute exacerbation of chronic knee osteoarthritis: a randomized clinical trial.
N Am J Med Sci, 5 (2013), pp. 108
K. Hawkins, F. Ghazi.
The addition of a supervised exercise class to a home exercise programme in the treatment of patients with knee osteoarthritis following corticosteroid injection: a pilot study.
Int Musculoskelet Med, 34 (2012), pp. 159-165
K.W. Kane, M.B. Suhas, M. Amita.
Effect of iliotibial band stretching on pain and functional activities in patients with knee osteoarthritis.
Indian J Physiother Occup Ther, 7 (2013), pp. 102
M.A. Mont, J.J. Cherian, A. Bhave, et al.
Unloader bracing for knee osteoarthritis: a pilot study of gait and function.
Surg Technol Int, 27 (2015), pp. 287-293
N. Parfitt, D. Parfitt.
The effects of exercise following a corticosteroid injection for knee osteoarthritis: a pilot study.
null, 28 (2006), pp. 80-84
D. Rabago, R. Kijowski, M. Woods, et al.
Association between disease-specific quality of life and magnetic resonance imaging outcomes in a clinical trial of prolotherapy for knee osteoarthritis.
Arch Phys Med Rehabil, 94 (2013), pp. 2075-2082
S. Kilinc, D.D. Kabayel, F. Ozdemir.
Comparison of the effectiveness of isokinetic exercise vs isometric exercise performed at different angles in patients with knee osteoarthritis.
Isokinet Exerc Sci, (2020), pp. 1-12
S.L. Oh, D.Y. Kim, J.H. Bae, J.Y. Lim.
Effects of rural community-based integrated exercise and health education programs on the mobility function of older adults with knee osteoarthritis.
E.U. Güvendi.
Comparison of efficiency between corticosteroid and platelet rich plasma injection therapies in patients with knee osteoarthritis.
Arch Rheumatol, 33 (2018), pp. 273-281
L. Wang, H. Chen, H. Lu, et al.
The effect of transtheoretical model-lead intervention for knee osteoarthritis in older adults: a cluster randomized trial.
Arthritis Res Ther, 22 (2020), pp. 134
N. Zeya, F. Yamin, A. ur Rehman, et al.
To compare the effectiveness of supervised clinical exercises and manual therapy of the knee joint with home based exercises.
Website: www ijpot com, 11 (2017), pp. 201
W.J. Chang, K.L. Bennell, P.W. Hodges, et al.
Addition of transcranial direct current stimulation to quadriceps strengthening exercise in knee osteoarthritis: a pilot randomised controlled trial.
PLoS One, 12 (2017),
R. Dumais, C. Benoit, A. Dumais, et al.
Effect of regenerative injection therapy on function and pain in patients with knee osteoarthritis: a randomized crossover study.
F. Farzad, H. Behnam Vashani, A. Azhari, M.H. Jokar.
Effects of In-Person and distance exercise training on outcomes of knee injury and osteoarthritis among elderly individuals with limited literacy.
Evidence Based Care, 8 (2018), pp. 45-54
K.K.W. Ho, A.W.L. Kwok, W.W. Chau, S.M. Xia, Y.L. Wang, J.C.Y. Cheng.
A randomized controlled trial on the effect of focal thermal therapy at acupressure points treating osteoarthritis of the knee.
J Orthop Surg Res, 16 (2021), pp. 282
C.D. Liao, Y.H. Liao, T.H. Liou, C.Y. Hsieh, Y.C. Kuo, H.C. Chen.
Effects of protein-rich nutritional composition supplementation on sarcopenia indices and physical activity during resistance exercise training in older women with knee osteoarthritis.
Nutrients, 13 (2021), pp. 2487
G. Nambi, W. Abdelbasset, S. Alrawaili, et al.
Effects of isokinetic knee muscle training on bone morphogenetic proteins and inflammatory biomarkers in post-traumatic osteoarthritis after anterior cruciate ligament injury: a randomized trial.
J Rehabil Med, 52 (2020), pp. jrm00098
N.A. de Morton.
The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study.
Aust J Physiother, 55 (2009), pp. 129-133
S. Armijo-Olivo, B.R. da Costa, G.G. Cummings, et al.
PEDro or Cochrane to assess the quality of clinical trials? A meta-epidemiological study.
PLoS One, 10 (2015),
T. Levy, K. Laver, M. Killington, N. Lannin, M. Crotty.
A systematic review of measures of adherence to physical exercise recommendations in people with stroke.
Clin Rehabil, 33 (2019), pp. 535-545
J.H. Abbott, M.C. Robertson, C. Chapple, et al.
Manual therapy, exercise therapy, or both, in addition to usual care, for osteoarthritis of the hip or knee: a randomized controlled trial. 1: clinical effectiveness.
Osteoarthritis Cartilage, 21 (2013), pp. 525-534
D. Beckwée, I. Bautmans, T. Scheerlinck, P. Vaes.
Exercise in knee osteoarthritis–preliminary findings: exercise-induced pain and health status differs between drop-outs and retainers.
Exp Gerontol, 72 (2015), pp. 29-37
K.L. Bennell, R.S. Hinman, B.R. Metcalf, et al.
Efficacy of physiotherapy management of knee joint osteoarthritis: a randomised, double blind, placebo controlled trial.
Ann Rheum Dis, 64 (2005), pp. 906-912
K.L. Bennell, M.A. Hunt, T.V. Wrigley, et al.
Hip strengthening reduces symptoms but not knee load in people with medial knee osteoarthritis and varus malalignment: a randomised controlled trial.
Osteoarthritis Cartilage, 18 (2010), pp. 621-628
K.L. Bennell, M. Kyriakides, B. Metcalf, et al.
Neuromuscular versus quadriceps strengthening exercise in patients with medial knee osteoarthritis and varus malalignment: a randomized controlled trial.
Arthritis Rheumatol, 66 (2014), pp. 950-959
T. Bezalel, E. Carmeli, M. Katz-Leurer.
The effect of a group education programme on pain and function through knowledge acquisition and home-based exercise among patients with knee osteoarthritis: a parallel randomised single-blind clinical trial.
Physiotherapy, 96 (2010), pp. 137-143
J.M. Brismée, R.L. Paige, M.C. Chyu, et al.
Group and home-based tai chi in elderly subjects with knee osteoarthritis: a randomized controlled trial.
Clin Rehabil, 21 (2007), pp. 99-111
L. Brosseau, G.A. Wells, G.P. Kenny, et al.
The implementation of a community-based aerobic walking program for mild to moderate knee osteoarthritis (OA): a knowledge translation (KT) randomized controlled trial (RCT): part I: the uptake of the Ottawa panel clinical practice guidelines (CPGs).
BMC Public Health, 12 (2012),
K. Chaipinyo, O. Karoonsupcharoen.
No difference between home-based strength training and home-based balance training on pain in patients with knee osteoarthritis: a randomised trial.
Aust J Physiother, 55 (2009), pp. 25-30
K. Cheawthamai, M. Vongsirinavarat, V. Hiengkaew, S. Saengrueangrob.
A comparison of home-based exercise programs with and without self-manual therapy in individuals with knee osteoarthritis in community.
J Med Assoc Thai, 97 (2014), pp. S95-S100
C. Cheung, J.F. Wyman, B. Resnick, K. Savik.
Yoga for managing knee osteoarthritis in older women: a pilot randomized controlled trial.
BMC Complement Altern Med, 14 (2014), pp. 160
R. Christensen, M. Henriksen, A.R. Leeds, et al.
Effect of weight maintenance on symptoms of knee osteoarthritis in obese patients: a twelve-month randomized controlled trial.
Arthritis Care Res, 67 (2015), pp. 640-650
K.M. Crossley, B. Vicenzino, J. Lentzos, et al.
Exercise, education, manual-therapy and taping compared to education for patellofemoral osteoarthritis: a blinded, randomised clinical trial.
Osteoarthritis Cartilage, 23 (2015), pp. 1457-1464
P. Doiron-Cadrin, D. Kairy, P.A. Vendittoli, V. Lowry, S. Poitras, F. Desmeules.
Feasibility and preliminary effects of a tele-prehabilitation program and an in-person prehablitation program compared to usual care for total hip or knee arthroplasty candidates: a pilot randomized controlled trial.
Disabil Rehabil, 42 (2020), pp. 989-998
J. Dunning, R. Butts, I. Young, et al.
Periosteal electrical dry needling as an adjunct to exercise and manual therapy for knee osteoarthritis: a multicenter randomized clinical trial.
Clin J Pain, 34 (2018), pp. 1149-1158
B.W. Lim, R.S. Hinman, T.V. Wrigley, L. Sharma, K.L. Bennell.
Does knee malalignment mediate the effects of quadriceps strengthening on knee adduction moment, pain, and function in medial knee osteoarthritis? A randomized controlled trial.
Arthritis Rheum, 59 (2008), pp. 943-951
D. Hernandez, M. Dimaro, E. Navarro, et al.
Efficacy of core exercises in patients with osteoarthritis of the knee: a randomized controlled clinical trial.
J Bodyw Mov Ther, 23 (2019), pp. 881-887
R.S. Hinman, S.E. Heywood, A.R. Day.
Aquatic physical therapy for hip and knee osteoarthritis: results of a single-blind randomized controlled trial.
Phys Ther, 87 (2007), pp. 32-43
M.A. Hunt, F.J. Keefe, C. Bryant, et al.
A physiotherapist-delivered, combined exercise and pain coping skills training intervention for individuals with knee osteoarthritis: a pilot study.
M.A. Hunt, C.L. Pollock, V.B. Kraus, et al.
Relationships amongst osteoarthritis biomarkers, dynamic knee joint load, and exercise: results from a randomized controlled pilot study.
BMC Musculoskelet Disord, 14 (2013), pp. 115
J. Rittharomya, S. Aree-ue, P. Malathum, P. Orathai, B. Belza, V. Kawinwonggowit.
The effectiveness of preoperative quadriceps exercise and diet control program for older adults waiting for total knee arthroplasty: a randomized controlled trial.
PRIJNR, 24 (2020), pp. 485-501
V. Kuptniratsaikul, C. Kittichaikarn, P. Suntornpiyapan, K. Kovintaset, S. Inthibal.
Is four-week underwater treadmill exercise regimen compared to home exercise efficacious for pain relief and functional improvement in obese patients with knee osteoarthritis? A randomized controlled trial.
Clin Rehabil, 33 (2019), pp. 85-93
S. León-Ballesteros, R. Espinosa-Morales, P. Clark-Peralta, A.G. Gómez-Pineda, J.H. Guadarrama-Becerril.
Kinesiotape and quadriceps strengthening with elastic band in women with knee osteoarthritis and overweight or obesity. A randomized clinical trial.
Reumatol Clin, 16 (2020), pp. 11-16
V. Lun, A. Marsh, R. Bray, D. Lindsay, P. Wiley.
Efficacy of hip strengthening exercises compared with leg strengthening exercises on knee pain, function, and quality of life in patients with knee osteoarthritis.
I. Mangani, M. Cesari, S.B. Kritchevsky, et al.
Physical exercise and comorbidity. Results from the fitness and arthritis in seniors trial (FAST).
Aging Clin Exp Res, 18 (2006), pp. 374-380
S.P. Messier, S.L. Mihalko, C. Legault, et al.
Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial.
JAMA, 310 (2013), pp. 1263-1273
N. Østerås, T. Moseng, L. van Bodegom-Vos, et al.
Implementing a structured model for osteoarthritis care in primary healthcare: a stepped-wedge cluster-randomised trial.
PLoS Med, 16 (2019),
P. Peungsuwan, P. Sermcheep, P. Harnmontree, et al.
The effectiveness of thai exercise with traditional massage on the pain, walking ability and QOL of older people with knee osteoarthritis: a randomized controlled trial in the community.
J Phys Ther Sci, 26 (2014), pp. 139-144
M. Rattanachaiyanont, V. Kuptniratsaikul.
No additional benefit of shortwave diathermy over exercise program for knee osteoarthritis in peri-/post-menopausal women: an equivalence trial.
Osteoarthritis Cartilage, 16 (2008), pp. 823-828
M.W. Rogers, N. Tamulevicius, S.J. Semple, Z. Krkeljas.
Efficacy of home-based kinesthesia, balance & agility exercise training among persons with symptomatic knee osteoarthritis.
J Sports Sci Med, 11 (2012), pp. 751-758
E.A. Schlenk, G. Kelley Fitzgerald, J.C. Rogers, C. Kent Kwoh, S.M Sereika.
Promoting physical activity in older adults with knee osteoarthritis and hypertension: a randomized controlled trial.
J Aging Phys Act, 29 (2020), pp. 207-218
A.M.M. Schoo, M.E. Morris, Q.M. Bui.
The effects of mode of exercise instruction on compliance with a home exercise program in older adults with osteoarthritis.
Physiotherapy, 91 (2005), pp. 79-86
R.W.S. Sit, K.K.W. Chan, D. Zou, et al.
Clinic-based patellar mobilization therapy for knee osteoarthritis: a randomized clinical trial.
Ann Fam Med, 16 (2018), pp. 521-529
R. Song, E.O. Lee, P. Lam, S.C. Bae.
Effects of tai chi exercise on pain, balance, muscle strength, and perceived difficulties in physical functioning in older women with osteoarthritis: a randomized clinical trial.
J Rheumatol, 30 (2003), pp. 2039-2044
S. Stensrud, M.A. Risberg, E.M. Roos.
Effect of exercise therapy compared with arthroscopic surgery on knee muscle strength and functional performance in middle-aged patients with degenerative meniscus tears: a 3-mo follow-up of a randomized controlled trial.
Am J Phys Med Rehabil, 94 (2015), pp. 460-473
Y. Suzuki, H. Iijima, Y. Tashiro, et al.
Home exercise therapy to improve muscle strength and joint flexibility effectively treats pre-radiographic knee OA in community-dwelling elderly: a randomized controlled trial.
Clin Rheumatol, 38 (2019), pp. 133-141
J. Takacs, N.M. Krowchuk, S.J. Garland, M.G. Carpenter, M.A. Hunt.
Dynamic balance training improves physical function in individuals with knee osteoarthritis: a pilot randomized controlled trial.
Arch Phys Med Rehabil, 98 (2017), pp. 1586-1593
K.S. Thomas, K.R. Muir, M. Doherty, A.C. Jones, S.C. O'Reilly, E.J Bassey.
Home based exercise programme for knee pain and knee osteoarthritis: randomised controlled trial.
R. Topp, S. Woolley, J. Hornyak 3rd, S. Khuder, B. Kahaleh.
The effect of dynamic versus isometric resistance training on pain and functioning among adults with osteoarthritis of the knee.
Arch Phys Med Rehabil, 83 (2002), pp. 1187-1195
C. Wang, C.H. Schmid, P.L. Hibberd, et al.
Tai Chi is effective in treating knee osteoarthritis: a randomized controlled trial.
Arthritis Rheum, 61 (2009), pp. 1545-1553
K. Azma, Z. RezaSoltani, F. Rezaeimoghaddam, A. Dadarkhah, S. Mohsenolhosseini.
Efficacy of tele-rehabilitation compared with office-based physical therapy in patients with knee osteoarthritis: a randomized clinical trial.
J Telemed Telecare, 24 (2018), pp. 560-565
K.L. Bennell, Y. Ahamed, G. Jull, et al.
Physical therapist-delivered pain coping skills training and exercise for knee osteoarthritis: randomized controlled trial.
Arthritis Care Res, 68 (2016), pp. 590-602
K.L. Bennell, R. Nelligan, F. Dobson, et al.
Effectiveness of an internet-delivered exercise and pain-coping skills training intervention for persons with chronic knee pain.
Ann Intern Med, 166 (2017), pp. 453
K.L. Bennell, P.K. Campbell, T. Egerton, et al.
Telephone coaching to enhance a home-based physical activity program for knee osteoarthritis: a randomized clinical trial.
Arthritis Care Res (Hoboken), 69 (2017), pp. 84-94
K.L. Bennell, R.K. Nelligan, A.J. Kimp, et al.
What type of exercise is most effective for people with knee osteoarthritis and co-morbid obesity?: the TARGET randomized controlled trial.
Osteoarthrit Cartilage, 28 (2020), pp. 755-765
R.A. Bruce-Brand, R.J. Walls, J.C. Ong, B.S. Emerson, J.M. O'Byrne, N.M Moyna.
Effects of home-based resistance training and neuromuscular electrical stimulation in knee osteoarthritis: a randomized controlled trial.
BMC Musculoskelet Disord, 13 (2012), pp. 118
H. Chen, Y. Wang, C. Liu, et al.
Benefits of a transtheoretical model-based program on exercise adherence in older adults with knee osteoarthritis: a cluster randomized controlled trial.
J Adv Nurs, 76 (2020), pp. 1765-1779
C. Cheung, J.F. Wyman, U. Bronas, T. McCarthy, K. Rudser, M.A. Mathiason.
Managing knee osteoarthritis with yoga or aerobic/strengthening exercise programs in older adults: a pilot randomized controlled trial.
Rheumatol Int, 37 (2017), pp. 389-398
T. Doi, M. Akai, K. Fujino, et al.
Effect of home exercise of quadriceps on knee osteoarthritis compared with nonsteroidal antiinflammatory drugs: a randomized controlled trial.
Am J Phys Med Rehabil, 87 (2008), pp. 258-269
J. Ebnezar, R. Nagarathna, B. Yogitha, H.R. Nagendra.
Effects of an integrated approach of hatha yoga therapy on functional disability, pain, and flexibility in osteoarthritis of the knee joint: a randomized controlled study.
J Altern Complement Med, 18 (2012), pp. 463-472
G.K. Fitzgerald, G. Kelley Fitzgerald, S.R. Piva, et al.
Agility and perturbation training techniques in exercise therapy for reducing pain and improving function in people with knee osteoarthritis: a randomized clinical trial.
Phys Ther, 91 (2011), pp. 452-469
L. Loew, L. Brosseau, G.P. Kenny, et al.
An evidence-based walking program among older people with knee osteoarthritis: the PEP (participant exercise preference) pilot randomized controlled trial.
Clin Rheumatol, 36 (2017), pp. 1607-1616
G.D. Miller, W.J. Rejeski, J.D. Williamson, et al.
The arthritis, diet and activity promotion trial (ADAPT): design, rationale, and baseline results.
Control Clin Trials, 24 (2003), pp. 462-480
A.C. Odole, O.D. Ojo.
A telephone-based physiotherapy intervention for patients with osteoarthritis of the knee.
Int J Telerehabil, 5 (2013), pp. 11-20
E.A. Schlenk, J.L. Lias, S.M. Sereika, J. Dunbar-Jacob, C.K. Kwoh.
Improving physical activity and function in overweight and obese older adults with osteoarthritis of the knee: a feasibility study.
R. Song, B.L. Roberts, E.O. Lee, P. Lam, S.C. Bae.
A randomized study of the effects of t'ai chi on muscle strength, bone mineral density, and fear of falling in women with osteoarthritis.
J Alternat Complement Med, 16 (2010), pp. 227-233
A.M. Swank, J.B. Kachelman, W. Bibeau, et al.
Prehabilitation before total knee arthroplasty increases strength and function in older adults with severe osteoarthritis.
J Strength Cond Res, 25 (2011), pp. 318-325
L.A. Talbot, J.M. Gaines, T.N. Huynh, E. Jeffrey Metter.
A home-based pedometer-driven walking program to increase physical activity in older adults with osteoarthritis of the knee: a preliminary study.
J Am Geriatr Soc, 51 (2003), pp. 387-392
J.A. Wallis, K.E. Webster, P. Levinger, P.J. Singh, C. Fong, N.F. Taylor.
A walking program for people with severe knee osteoarthritis did not reduce pain but may have benefits for cardiovascular health: a phase II randomised controlled trial.
Osteoarthrit Cartilage, 25 (2017), pp. 1969-1979
J. Ye, Q. Zheng, L. Zou, et al.
Mindful exercise (Baduanjin) as an adjuvant treatment for older adults (60 years old and over) of knee osteoarthritis: a randomized controlled trial.
Evid Based Complement Alternat Med, 2020 (2020),
G.D. Miller, B.J. Nicklas, C. Davis, R.F. Loeser, L. Lenchik, S.P. Messier.
Intensive weight loss program improves physical function in older obese adults with knee osteoarthritis*.
Obesity, 14 (2006), pp. 1219-1230
T. Altınbilek, S. Murat, Y. Yumuşakhuylu, A. İçağasıoğlu.
Osteopathic manipulative treatment improves function and relieves pain in knee osteoarthritis: a single-blind, randomized-controlled trial.
Turk J Phys Med Rehabil, 64 (2018), pp. 114-120
S.M. Chen, F.C. Shen, J.F. Chen, W.D. Chang, N.J. Chang.
Effects of resistance exercise on glycated hemoglobin and functional performance in older patients with comorbid diabetes mellitus and knee osteoarthritis: a randomized trial.
Int J Environ Res Public Health, 17 (2020), pp. 224
A. Gur, A. Cosut, A.J. Sarac, R. Cevik, K. Nas, A. Uyar.
Efficacy of different therapy regimes of low-power laser in painful osteoarthritis of the knee: a double-blind and randomized-controlled trial.
Lasers Surg Med, 33 (2003), pp. 330-338
Y.I. Hsu, Y.C. Chen, C.L. Lee, N.J. Chang.
Effects of diet control and telemedicine-based resistance exercise intervention on patients with obesity and knee osteoarthritis: a randomized control trial.
Int J Environ Res Public Health, 18 (2021),
T. Kuru Çolak, B. Kavlak, O. Aydoğdu, et al.
The effects of therapeutic exercises on pain, muscle strength, functional capacity, balance and hemodynamic parameters in knee osteoarthritis patients: a randomized controlled study of supervised versus home exercises.
Rheumatol Int, 37 (2017), pp. 399-407
P.E. McKnight, S. Kasle, S. Going, et al.
A comparison of strength training, self-management, and the combination for early osteoarthritis of the knee.
Arthritis Care Res, 62 (2010), pp. 45-53
S.P. Messier, S. Mihalko, R.F. Loeser, et al.
Glucosamine/chondroitin combined with exercise for the treatment of knee osteoarthritis: a preliminary study.
Osteoarthritis Cartilage, 15 (2007), pp. 1256-1266
J. Park, R. McCaffrey, D. Newman, P. Liehr, J.G. Ouslander.
A pilot randomized controlled trial of the effects of chair yoga on pain and physical function among community-dwelling older adults with lower extremity osteoarthritis.
J Am Geriatr Soc, 65 (2017), pp. 592-597
D. Rabago, J.J. Patterson, M. Mundt, et al.
Dextrose prolotherapy for knee osteoarthritis: a randomized controlled trial.
Ann Fam Med, 11 (2013), pp. 229-237
Z. Zhong, B. Liu, G. Liu, et al.
A randomized controlled trial on the effects of low-dose extracorporeal shockwave therapy in patients with knee osteoarthritis.
Arch Phys Med Rehabil, 100 (2019), pp. 1695-1702
M. Sharma, A. Singh, M.S. Dhillon, S. Kaur.
Comparative impact of nonpharmacological interventions on pain of knee osteoarthritis patients reporting at a tertiary care institution: a randomized controlled trial.
Indian J Palliat Care, 24 (2018), pp. 478-485
K. Baker, M.P. LaValley, C. Brown, D.T. Felson, A. Ledingham, J.J. Keysor.
Efficacy of computer-based telephone counseling on long-term adherence to strength training in elderly patients with knee osteoarthritis: a randomized trial.
Arthritis Care Res, 72 (2020), pp. 982-990
K.L. Bennell, M. Kyriakides, P.W. Hodges, R.S. Hinman.
Effects of two physiotherapy booster sessions on outcomes with home exercise in people with knee osteoarthritis: a randomized controlled trial.
Arthritis Care Res, 66 (2014), pp. 1680-1687
M.A. Elbadawy.
Effectiveness of periosteal stimulation therapy and home exercise program in the rehabilitation of patients with advanced knee osteoarthritis.
Clin J Pain, 33 (2017), pp. 254-263
N.E. Foster, E. Thomas, P. Barlas, et al.
Acupuncture as an adjunct to exercise based physiotherapy for osteoarthritis of the knee: randomised controlled trial.
C. Veenhof, A.J.A. Köke, J. Dekker, et al.
Effectiveness of behavioral graded activity in patients with osteoarthritis of the hip and/or knee: a randomized clinical trial.
Arthritis Rheum, 55 (2006), pp. 925-934
K.D. Allen, D. Bongiorni, H.B. Bosworth, et al.
Group versus individual physical therapy for veterans with knee osteoarthritis: randomized clinical trial.
Phys Ther, 96 (2016), pp. 597-608
K. Bennell, R.K. Nelligan, S. Schwartz, et al.
Behavior change text messages for home exercise adherence in knee osteoarthritis: randomized trial.
J Med Internet Res, 22 (2020), pp. e21749
C.J. McCarthy, P.M. Mills, R. Pullen, C. Roberts, A. Silman, J.A. Oldham.
Supplementing a home exercise programme with a class-based exercise programme is more effective than home exercise alone in the treatment of knee osteoarthritis.
Rheumatology, 43 (2004), pp. 880-886
D. O'Brien, S. Bassett, P. McNair.
The effect of action and coping plans on exercise adherence in people with lower limb osteoarthritis: a feasibility study.
NZJ Physiother, 41 (2013), pp. 49-57
S. Palmer, M. Domaille, F. Cramp, et al.
Transcutaneous electrical nerve stimulation as an adjunct to education and exercise for knee osteoarthritis: a randomized controlled trial.
Arthritis Care Res, 66 (2014), pp. 387-394
J.N. Farr, S.B. Going, P.E. McKnight, S. Kasle, E.C. Cussler, M. Cornett.
Progressive resistance training improves overall physical activity levels in patients with early osteoarthritis of the knee: a randomized controlled trial.
Phys Ther, 90 (2010), pp. 356-366
M. de Rooij, M. van der Leeden, J. Cheung, et al.
Efficacy of tailored exercise therapy on physical functioning in patients with knee osteoarthritis and comorbidity: a randomized controlled trial.
Arthritis Care Res, 69 (2017), pp. 807-816
J. Knoop, J. Dekker, M. van der Leeden, et al.
Knee joint stabilization therapy in patients with osteoarthritis of the knee: a randomized, controlled trial.
Osteoarthrit Cartilage, 21 (2013), pp. 1025-1034
P. Nejati, A. Farzinmehr, M. Moradi-Lakeh.
The effect of exercise therapy on knee osteoarthritis: a randomized clinical trial.
Med J Islam Repub Iran, 29 (2015), pp. 186
F. Wang, X. Zhang, X. Tong, et al.
The effects on pain, physical function, and quality of life of quadriceps strengthening exercises combined with Baduanjin qigong in older adults with knee osteoarthritis: a quasi-experimental study.
BMC Musculoskelet Disord, 22 (2021),
C.M. Xiao, J.J. Li, Y. Kang, Y.C. Zhuang.
Follow-up of a Wuqinxi exercise at home programme to reduce pain and improve function for knee osteoarthritis in older people: a randomised controlled trial.
Age Ageing, 50 (2021), pp. 570-575
Y. Hiyama, M. Yamada, A. Kitagawa, N. Tei, S. Okada.
A four-week walking exercise programme in patients with knee osteoarthritis improves the ability of dual-task performance: a randomized controlled trial.
Clin Rehabil, 26 (2012), pp. 403-412
A.E. Mikesky, S.A. Mazzuca, K.D. Brandt, S.M. Perkins, T. Damush, K.A. Lane.
Effects of strength training on the incidence and progression of knee osteoarthritis.
Arthrit Rheumatism, 55 (2006), pp. 690-699
W.J. Rejeski, W. Jack Rejeski, B.C. Focht, et al.
Obese, older adults with knee osteoarthritis: weight loss, exercise, and quality of life.
Health Psychol, 21 (2002), pp. 419-426
V. Duong, M.S. Daniel, M.L. Ferreira, et al.
Measuring adherence to unsupervised, conservative treatment for knee osteoarthritis: a systematic review.
Osteoarthrit Cartilage Open, (2021),
S. McLean, M.A. Holden, T. Potia, et al.
Quality and acceptability of measures of exercise adherence in musculoskeletal settings: a systematic review.
Rheumatology, 56 (2017), pp. 426-438
Mclean S., Holden M., Haywood K., et al. Recommendations for exercise adherence measures in musculoskeletal settings: a systematic review and consensus meeting. Published online 2014. Accessed February 28, 2021.
N. Newman-Beinart, J. Weinman, S. Norton, E. Godfrey.
A measure to assess adherence to prescribed home exercise: the exercise adherence rating scale (EARS).
Eur Health Psych, (2016),
Adaptation and validation of the exercise adherence rating scale of knee osteoarthritis patients (GONEARS) - full text view - ClinicalTrials.Gov. Accessed May 30, 2022.
M. Kudo, K. Watanabe, H. Otsubo, et al.
Analysis of effectiveness of therapeutic exercise for knee osteoarthritis and possible factors affecting outcome.
J Orthopaed Sci, 18 (2013), pp. 932-939
P.J.A. Nicolson, R.S. Hinman, T.V. Wrigley, P.W. Stratford, K.L. Bennell.
Self-reported home exercise adherence: a validity and reliability study using concealed accelerometers.
J Orthop Sports Phys Ther, 48 (2018), pp. 943-950
R. Frost, D. McClurg, M. Brady, B. Williams.
Optimising the validity and completion of adherence diaries: a multiple case study and randomised crossover trial.
R. Frost, S. Levati, D. McClurg, M. Brady, B. Williams.
What adherence measures should be used in trials of home-based rehabilitation interventions? A systematic review of the validity, reliability, and acceptability of measures.
Arch Phys Med Rehabil, 98 (2017), pp. 1241-1256
Food and drug administration, Department of health and human services. 21CFR312.23. Accessed June 5, 2021.
C.J.J. Kloek, D. Bossen, P.M. Spreeuwenberg, J. Dekker, D.H. de Bakker, C. Veenhof.
Effectiveness of a blended physical therapist intervention in people with hip osteoarthritis, knee osteoarthritis, or both: a cluster-randomized controlled trial.
Phys Ther, 98 (2018), pp. 560-570
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