What treatments should I be providing for my patients with knee osteoarthritis?

National estimates indicate that knee osteoarthritis is associated with over 59,000 years lived with disability annually.

Low value care (care that is wasteful, ineffective and/or harmful) is still offered to this population.

An editorial by Professor Ilana Ackerman and co-authors introduces the updated clinical care standard for knee osteoarthritis.

It aims to support the delivery of evidence-based clinical care for a health condition or procedure, reduce variation in clinical care across Australia and promote shared decision-making between health professionals and consumers.

New developments within the clinical care standard include a stronger focus on clinical diagnosis and avoidance of unnecessary imaging, new advice on weight management and nutrition, physical activity recommendations, applicability to a broad range of settings and links to evidence-based consumer resources.

How can I supplement exercise for shoulder pain?

Rotator cuff-related shoulder pain is a broad term that encompasses a variety of shoulder conditions such as subacromial impingement syndrome, rotator cuff tendinopathy and bursitis.

Conservative therapy is considered the first-line treatment for such pain, with exercise being a main option.

A new trial conducted in Brazil examined the effect of adding Mulligan mobilisation with movement to a standard exercise program in people with chronic atraumatic shoulder pain.

Adding mobilisation with movement led to improvements in function, pain at night, pain on movement and active range of movement into flexion, abduction, external rotation and hand behind back at the end of the five-week intervention period.

Many of these benefits were still evident four weeks later.

Should I use non-invasive ventilation after thoracic surgery?

Journal of Physiotherapy scientific editor Mark Elkins unpacks the latest research published in the journal.

Thoracic surgical techniques have improved but postoperative pulmonary complications are not uncommon.

An international group of physiotherapists systematically reviewed the evidence from 16 randomised trials examining the prophylactic use of non-invasive ventilation after thoracic surgery.

Non-invasive ventilation reduced postoperative pulmonary complications and length of hospital stay.

It had no adverse effects on intubation, mortality or adverse events, indicating that it is safe.

Is priming effective after stroke?

A group of Australian physiotherapists led by Simone Dorsch systematically reviewed trial of priming prior to task-specific practice in people after stroke.

They found 24 trials that examined various types of priming: motor imagery, action observation, mirror therapy, movement-based priming, aerobic exercise-based priming and combined motor imagery and action observation.

Motor imagery priming improved motor impairment and activity-related outcomes.

Action observation and aerobic exercise each improved activity outcomes.

These and other original research papers are supplemented by a diverse range of critically appraised papers, clinical practice guidelines, clinimetric summaries of outcome measures and other appraisal items.

>> Head to journal.physio to read the research.

>> Clinical Associate Professor Mark Elkins APAM is the scientific editor of Journal of Physiotherapy. Follow him on X @JOP_Editor and follow Journal of Physiotherapy @JPhysiother

Course of interest:

The everyday shoulder