Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.

An Update of the Dutch Physical Therapy Guideline on Hip and Knee Osteoarthritis (HKOA).

Peter5,  Wilfred F. H., Jansen1,  Mariette J., Hurkmans6,  Emalie J., Bloo12,  Hans, Dekker-Bakker11,  Leatitia M. M. C. J., Dilling10,  Roelien G., Hilberdink10,  Wim K. H. A.

Centre for Evidence Based Physiotherapy (CEBP), University of Maastricht, Maastricht, The Netherlands
Paramedical Center for Rheumatology and Rehabilitation, Groningen, The Netherlands
Physical Therapy Private Practice, Amstelveen, The Netherlands
Veenendaal en Roessingh Research & Development, Enschede, The Netherlands
Walaeus Library, Leiden University Medical Center, Leiden, The Netherlands
Department of Physical Therapy, LUMC, Leiden, The Netherlands
Department of Physical Therapy, St. Maartenskliniek, Nijmegen, The Netherlands
Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden, The Netherlands, Dept of Orthopaedics, Leiden, University Medical Center
Department of Rheumatology, Leiden University Medical Center (LUMC); Jan van Breemen Instituut, Centre for Rheumatology and Rehabilitation, Amsterdam, Leiden, The Netherlands
Dept of Rheumatology, Leiden, University Medical Center
Exercise Therapy Private Practice, Leiden, The Netherlands
Jan van Breemen Instituut, Centre for Rheumatology and Rehabilitation, Amsterdam, The Netherlands
Netherlands Institute for Health Services Research, Utrecht, The Netherlands


In 2001 the Royal Dutch Society for Physical Therapy (KNGF) Guideline for hip and knee osteoarthritis (HKOA) was developed. Since then, many scientific papers on physical therapy interventions as well as national and international guidelines were published.


To update the physical therapy guideline based on current evidence and best practice.


Topics concerning the three guideline chapters: initial assessment, treatment and evaluation were selected by a guideline development committee consisting of 10 expert physical therapists. With respect to treatment a systematic literature search (up to June 2009) within various databases was performed aiming to identify reviews and randomized controlled trials (RCTs) on the effectiveness of physical therapy interventions and the evidence was graded (1–4). For initial assessment and evaluation mainly review papers and textbooks were used. Based on evidence and expert opinion, recommendations were formulated (5 consensus meetings and 8 feedback rounds) and graded (A-D). A first draft of the guideline was reviewed by 17 experts from different professional backgrounds (2 feedback rounds). A second draft was field-tested by 45 physical therapists.


For the initial assessment, a description of relevant health related topics in HKOA was made according to the International Classification of Functioning, disability and health (ICF) core set for osteoarthritis (OA). Concerning treatment, 22 systematic reviews and 74 RCTs were reviewed. Recommended were: exercise therapy, education and self management interventions, a combination of exercise and manual therapy, and postoperative exercise therapy in HKOA, and taping of the patella in knee OA. Neither recommended nor advised against were: balneotherapy, hydrotherapy, and preoperative physical therapy in HKOA; thermotherapy, TENS, and Continuous Passive Motion in knee OA. Not recommended were: massage, ultrasound, electrotherapy, electromagnetic field and Low Level Laser Therapy. For the evaluation of treatment goals the use of one or more of the following measurement instruments was recommended: daily activities and participation: Lequesne index, Western Ontario and McMaster Universities osteoarthritis index questionnaire, Hip and Knee disability and Osteoarthritis Outcome Scores, 6 Minute Walk test, Timed Stand Up and Go test and Patient Specific Complaint list; body functions and structures: Visual Analogue Scale for pain, Intermittent and Constant OsteoArthritis Pain questionnaire, goniometry, Medical Research Council for strength, Handheld Dynamometer.


This update of the Dutch physical therapy guideline on HKOA included recommendations on the initial assessment, treatment and evaluation. The revised guideline will be launched in February 2010 and published on (including an English translation).

Members of the HKOA Guideline Development Committee:

H Bloo, L Dekker-Bakker, R Dilling, W Hilberdink, C Kersten-Smit, M de Rooij, C Veenhof, H Vermeulen, I de Vos.


This study was financially supported by the KNGF, Amersfoort, the Netherlands.

To cite this abstract, please use the following information:
Peter, Wilfred F. H., Jansen, Mariette J., Hurkmans, Emalie J., Bloo, Hans, Dekker-Bakker, Leatitia M. M. C. J., Dilling, Roelien G., et al; An Update of the Dutch Physical Therapy Guideline on Hip and Knee Osteoarthritis (HKOA). [abstract]. Arthritis Rheum 2010;62 Suppl 10 :2051
DOI: 10.1002/art.29816

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