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

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.