Effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: A systematic review of randomized clinical trials
Arthritis & RheumatismPublished 1 July 1999
Margriet E. van Baar, Willem JJ Assendelft, Joost Dekker, R.A.B. Oostendorp, J. W. J. Bijlsma
Citations439
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TL;DR
There is evidence of beneficial effects of exercise therapy in patients with OA of the hip or knee, however, the small number of good studies restricts drawing firm conclusions.
Abstract
There is evidence of beneficial effects of exercise therapy in patients with OA of the hip or knee. However, the small number of good studies restricts drawing firm conclusions.
Keywords
Medicine
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