The role of physical activity and therapeutic exercise in development and management of knee osteoarthritis

• Objective: To review the effects of physical activity and exercise on the onset and progression of knee osteoarthritis (OA) and to provide an overview of important research findings regarding the role of therapeutic exercise in the management of the disease. • Methods: Narrative review of the literature. • Results: Despite the common misconception that physical activity and exercise are harmful to a weight-bearing joint such as the knee, in the absence of injury there is no evidence to support such notion. It appears that participation in physical activity and exercise through childhood and adulthood may have beneficial and potentially protective effects against development of OA later in life. In addition, evidence supports the use of exercise therapy as a first line of effective disease management for people with knee OA in terms of reductions in knee pain and physical disability. However, whether exercise has a protective or an injurious effect with regards to disease progression in the setting of early joint damage remains unclear. Overall, exercise is grossly underused in clinical management of individuals with knee OA in spite of recommendations in published evidence-based guidelines. • Conclusions: Physical activity and therapeutic exercise play important roles in prevention, development, and management of knee OA. Future research in the field should help devise novel exercise interventions to more effectively manage symptoms and disease progression in individuals with knee OA.