Abstract
Background : Although non-pharmacological therapies for knee osteoarthritis (OA) are essential pillars of care, they are often poorly considered and inconsistently applied. Objectives : Under the umbrella of the French Society of Rheumatology (SFR) and the French Society of Physcal Medicine and Rehabilitation (SOFMER), we aimed to establish consensual recommendations for the non-pharmacological management of people with knee OA.Methods : A group of fellows performed a systematic literature review on the efficacy and safety of non-phamacological modalities (up to October 2021). The fellows then took part in discussions with a multidiscipliary group of experts to draft a list of recommendations. The list was then submitted to an independent reading committee who rated their level of agreement with each recommendation. Each recommendation was assigned a strength of recommendation and a level of evidence.Results : Five general principles were unanimously accepted : (A) the need to combine non-pharmacological and pharmacological measures ; (B) the need for personalized management ; (C) the need to promote adherence ; (D) the need for adapted physical activity ; and (E) the need for person-centered education. Specific positive or negative recommendations were defined for 11 modalities : (1) unloading knee brace ; (2) kinesio-taping or knee sleeves ;(3) shoes and/or insoles ; (4) using a cane ; (5) physical exercise program ; (6) joint mobilization ; (7) electro- or thermo-therapy ; (8) acupuncture ; (9) weight loss ; (10) thermal spa therapy ; and (11) workplace accommodation.Conclusions : These SFR/SOFMER recommendations provide important and consensual knowledge to assist health professionals in decision-making for non-pharmacological treatments for knee OA.