Ottawa Panel evidence-based clinical practice guidelines for therapeutic exercises in the management of rheumatoid arthritis in adults

Abstract

Background and purpose: The purpose of this project was to create guidelines for the use of therapeutic exercises and manual therapy in the management of adult patients (>18 years of age) with a diagnosis of rheumatoid arthritis according to the 1987 American Rheumatism Association criteria.

Methods: Evidence from comparative controlled trials was identified and synthesized using The Cochrane Collaboration methods. An expert panel was formed by inviting professional stakeholder organizations to each nominate a representative. This panel developed a set of criteria for grading the strength of both the evidence and the recommendation.

Results: Six positive recommendations of clinical benefit were developed on therapeutic exercises. The efficacy of manual therapy interventions could not be determined for lack of evidence.

Discussion and conclusion: The panel recommends the use of therapeutic exercises for rheumatoid arthritis. Further research is needed to determine the efficacy of manual therapy in the management of this disease.