Which physical therapy intervention has the highest level of evidence for treating knee osteoarthritis?

• A. Strength training exercises
• B. Manual therapy and exercise for lower extremity
• C. Hydrotherapy
• D. Electrical stimulation

Answer: (B)

The intervention recognized as having the highest level of evidence for treating knee osteoarthritis is manual therapy and exercise for the lower extremity. Numerous studies and systematic reviews support the effectiveness of combining manual therapy techniques with targeted exercise programs to improve functional outcomes and reduce pain in individuals with knee osteoarthritis. This approach not only addresses joint mobility and muscle strength but also enhances the overall biomechanics of the lower extremity.

Manual therapy, including joint mobilizations and soft tissue techniques, can alleviate the stiffness and discomfort often associated with osteoarthritis, while therapeutic exercises can strengthen the surrounding musculature, improve stability, and promote overall joint health. The synergistic effect of these interventions is particularly beneficial in managing knee osteoarthritis symptoms.

Other interventions, while beneficial, may not have as robust a body of evidence supporting their effectiveness in this specific population. Strength training exercises, for instance, are certainly valuable and supported by research, but they may not encompass the comprehensive approach that manual therapy and exercise together provide. Hydrotherapy and electrical stimulation can also play roles in treatment but generally do not have the same level of evidence demonstrating their effectiveness compared to the combination of manual therapy and exercise. This distinction is crucial for clinicians when developing treatment plans tailored to the needs of patients with knee osteoarthritis.