Physical Therapists’ Use of Therapeutic Exercise for Patients With Clinical Knee Osteoarthritis in the United Kingdom: In Line With Current Recommendations?

Abstract

Physical therapists have an important role in the management of clinical knee osteoarthritis (OA) through designing and supervising exercise programs. This study explored whether their current use of therapeutic exercise for patients with this condition is in line with recent recommendations. A cross-sectional survey was conducted with a random sample of chartered (licensed) physical therapists (N=2,000) practicing in the United Kingdom. This survey included a vignette describing a patient with clinical knee OA as well as clinical management questions relating to the respondents' use of therapeutic exercise. The questionnaire response rate was 58% (n=1,152), with 538 respondents stating they had treated a patient with clinical knee OA in the preceding 6 months. In line with recent recommendations, 99% of the physical therapists stated they would use therapeutic exercise for this patient population, although strengthening exercises were favored over aerobic exercises. Although nearly all physical therapists would monitor exercise adherence, only 12% would use an exercise diary. Seventy-six percent of physical therapists would provide up to 5 treatment sessions, and only 34% would offer physical therapy follow-up after discharge. The measure of physical therapists' current clinical practice was self-reported clinical behavior on the basis of a vignette. Although this is a valid measure of clinical behavior, in practice, physical therapists may use therapeutic exercise differently. There are disparities between physical therapists' current use of therapeutic exercise for clinical knee OA and recent recommendations. Identifying potential ways to overcome these disparities is an important step toward optimizing the outcome from therapeutic exercise for patients with clinical knee OA.