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.

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.