CER 77: Physical Therapy Interventions for Knee Pain ...

Comparative Effectiveness Review Number 77

Physical Therapy Interventions for Knee Pain Secondary to Osteoarthritis

Comparative Effectiveness Review

Number 77

Physical Therapy Interventions for Knee Pain Secondary to Osteoarthritis

Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 540 Gaither Road Rockville, MD 20850 Contract No. 290-2007-10064-I Prepared by: Minnesota Evidence-based Practice Center Minneapolis, MN

Investigators: Tatyana A. Shamliyan, M.D., M.S. Shi-Yi Wang, M.D., Ph.D. Becky Olson-Kellogg, P.T., D.P.T., G.C.S. Robert L. Kane, M.D.

AHRQ Publication No. 12(13)-EHC115-EF November 2012

This report is based on research conducted by the Minnesota Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2007-10064-I). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help health care decisionmakers--patients and clinicians, health system leaders, and policymakers, among others--make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.

This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.

This document is in the public domain and may be used and reprinted without special permission except those copyrighted materials that are clearly noted in the document. Further reproduction of those copyrighted materials is prohibited without the specific permission of copyright holders. Persons using assistive technology may not be able to fully access information in this report. For assistance contact EffectiveHealthCare@ahrq..

None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report.

Suggested citation: Shamliyan TA, Wang S-Y, Olson-Kellogg B, Kane RL. Physical Therapy Interventions for Knee Pain Secondary to Osteoarthritis. Comparative Effectiveness Review No. 77. (Prepared by the Minnesota Evidence-based Practice Center under Contract No. 290-200710064-I.) AHRQ Publication No. 12(13)-EHC115-EF. Rockville, MD: Agency for Healthcare Research and Quality; November 2012. effectivehealthcare.reports/final.cfm.

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Preface

The Agency for Healthcare Research and Quality (AHRQ) conducts the Effective Health Care Program as part of its mission to organize knowledge and make it available to inform decisions about health care. As part of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Congress directed AHRQ to conduct and support research on the comparative outcomes, clinical effectiveness, and appropriateness of pharmaceuticals, devices, and health care services to meet the needs of Medicare, Medicaid, and the Children's Health Insurance Program (CHIP).

AHRQ has an established network of Evidence-based Practice Centers (EPCs) that produce Evidence Reports/Technology Assessments to assist public- and private-sector organizations in their efforts to improve the quality of health care. The EPCs now lend their expertise to the Effective Health Care Program by conducting comparative effectiveness reviews (CERs) of medications, devices, and other relevant interventions, including strategies for how these items and services can best be organized, managed, and delivered.

Systematic reviews are the building blocks underlying evidence-based practice; they focus attention on the strength and limits of evidence from research studies about the effectiveness and safety of a clinical intervention. In the context of developing recommendations for practice, systematic reviews are useful because they define the strengths and limits of the evidence, clarifying whether assertions about the value of the intervention are based on strong evidence from clinical studies. For more information about systematic reviews, see effectivehealthcare.reference/purpose.cfm.

AHRQ expects that CERs will be helpful to health plans, providers, purchasers, government programs, and the health care system as a whole. In addition, AHRQ is committed to presenting information in different formats so that consumers who make decisions about their own and their family's health can benefit from the evidence.

Transparency and stakeholder input are essential to the Effective Health Care Program. Please visit the Web site (effectivehealthcare.) to see draft research questions and reports or to join an email list to learn about new program products and opportunities for input. Comparative Effectiveness Reviews will be updated regularly.

We welcome comments on this CER. They may be sent by mail to the Task Order Officer named below at: Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850, or by email to epc@ahrq..

Carolyn M. Clancy, M.D. Director Agency for Healthcare Research and Quality

Jean Slutsky, P.A., M.S.P.H. Director, Center for Outcomes and Evidence Agency for Healthcare Research and Quality

Stephanie Chang M.D., M.P.H. Director, EPC Program Center for Outcomes and Evidence Agency for Healthcare Research and Quality

Suchitra Iyer, Ph.D. Task Order Officer Center for Outcomes and Evidence Agency for Healthcare Research and Quality

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Acknowledgments

The authors gratefully acknowledge the following individuals for their contributions to this project: We would like to thank the librarian, Judy Stanke, M.A., for her contribution to the literature search; Rema Ramakrishnan, M.P.H., and Jae Young Choi, Ph.D. candidate, for their assistance with the literature search and data abstraction; Jeannine Ouellette for her help in writing the report; Marilyn Eells and Nancy Russell for editing and formatting the report; and Christa Prodzinski and Kirsten Johnson for assistance with data entry, quality control, and formatting tables.

Key Informants

G. Kelley Fitzgerald, Ph.D., P.T., O.C.S., FAPTA

University of Pittsburgh Pittsburgh, PA

Mark Haubner, B.A. Huntington, NY

Robin Katzanek, P.T., M.A., Ph.D. Liberty Physical Therapy Wakefield, RI

Timothy Kauffman, Ph.D., P.T. Private Practice Lancaster, PA

Alex Malter, M.D. Department of Health & Social Services Juneau, AK

Marilyn Moffat, P.T., D.P.T., Ph.D., D.Sc. (hon), FAPTA, CSGS, CEEAA

New York University New York, NY

Pam Snow Department of Human Resources Warner Robins, GA

Technical Expert Panel

Roy Altman, M.D. University of California Los Angeles, CA

Mary Bell, M.D. University of Toronto Toronto, Ontario

G. Kelley Fitzgerald, Ph.D., P.T., O.C.S., FAPTA

University of Pittsburgh Pittsburgh, PA

Marc Hochberg, M.D., M.P.H. University of Maryland School of Medicine Baltimore, MD

Carol Oatis, Ph.D., P.T. Arcadia University Philadelphia, PA

Jennifer Stevens-Lapsley, Ph.D., P.T. University of Colorado Denver, CO

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