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Does Osteoarthritis Physiotherapy Research in South Korea Align With the National Institute for Health and Care Excellence Guidelines: A Systematic Review of English and Korean Literature

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Journal Article

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Springer Science and Business Media LLC

Abstract

Background Osteoarthritis (OA) is a leading cause of lower limb disability worldwide, imposing significant socioeconomic and personal burden. Thus, many internationally recognised organisations have developed management guidelines for this condition. Among these, the National Institute for Health and Care Excellence (NICE) recommends four first-line approaches to osteoarthritis management: education, exercise, self-management, and weight management. Despite the development of guidelines, adherence to OA management recommendations appears to be suboptimal internationally, and little is known about guideline adherence in South Korea. This study aimed to explore whether research-based physiotherapy interventions for OA in South Korea align with the NICE guidelines. Methods A comprehensive search was conducted across multiple Korean and English electronic databases, including the Korea Citation Index (KCI), Korean Studies Information Service System (KISS), MEDLINE, EMBASE, CINAHL, SPORTDiscus SCOPUS, and Google Scholar. Twelve randomized controlled trials conducted in South Korea met the inclusion criteria, with sample sizes ranging from 20 to 60 participants. Participants’ mean age ranged from 57 to 75 years, and their Body Mass Index (BMI) varied from 23.00 to 25.68 kg/m². The primary outcome measure was the alignment of interventions with NICE OA guidelines, assessed using a scoring system (0–2 points per study) developed specifically for this review. Additionally, the methodological quality of included studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. Results Most studies had poor methodological quality (PEdro scale range: 3–5). Only 42% of the Korean studies aligned with the NICE OA recommendations. Commonly applied interventions were predominantly passive, such as heat therapy, electrotherapy, and kinesiology taping, none of which are recommended by NICE. Conclusions A discrepancy was found between research-based physiotherapy interventions for osteoarthritis in South Korea and the therapeutic approaches recommended by the National Institute for Health and Care Excellence guidelines. Factors such as a lack of evidence-based education, research, healthcare funding in South Korea, and cultural health experiences and expectations of the patients may have contributed to these findings. These results could help develop new strategies for improving osteoarthritis management in South Korea.

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BMC Rheumatology, ISSN: 2520-1026 (Online), Springer Science and Business Media LLC, 9(1). doi: 10.1186/s41927-025-00496-w

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© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.