Exercise is the most studied intervention and appears to provide modest benefits with respect to pain, function, and disability. Clinical practice guidelines and professional society guidelines have been developed based on expert opinion and a synthesis of the literature. All identify exercise as a main component of OA management (see Table 13-10). Some of the guidelines also support the use of assistive devices, orthotics, and self-management strategies.
In this paper, I focus predominantly on studies examining the effectiveness of rehabilitation interventions in people with hip and knee OA and synthesize the evidence when possible. In the section on manual therapy, I expand the review to include studies on OA of the spine. And although there are few studies examining hand OA, I include a section on that as well.