{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:32:47Z","timestamp":1760059967926,"version":"build-2065373602"},"reference-count":131,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Osteology"],"abstract":"<jats:p>Background\/Objectives: Knee osteoarthritis is one of the most significant diseases globally and in Portugal. Despite the availability of international guidelines, there is a lack of tailored, evidence-based recommendations specifically for Portuguese physiotherapists to manage their knee osteoarthritis patients with non-pharmacological and non-surgical interventions. This study aimed to develop a clinical practice guideline that integrates the latest international evidence with local clinical practice data to enhance patient outcomes. Methods: To achieve the objective, a comprehensive search was conducted in November 2024 across major health-related databases, to identify robust and recent evidence regarding the efficacy of non-pharmacological and non-surgical interventions, as well as their usage in the national context. Two key sources were identified: An umbrella and a mixed-methods study. Data from both sources were independently reviewed and integrated through a comparative analysis to identify interventions with robust scientific support and high local acceptability. Recommendations were then formulated and categorized into gold (strong), silver (moderate), and bronze (weak) levels based on evidence quality and clinical relevance. A decision-making flowchart was developed to support guideline implementation and clinical usage. Results: The integrated analysis identified three gold-level interventions, namely Nutrition\/Weight Loss, Resistance Exercise, and Self-care\/Education. Five silver-level recommendations were Aerobic Exercise, Balneology\/Spa, Extracorporeal Shockwave Therapy, Electrical Stimulation, and Manual Therapy. Similarly, five bronze-level recommendations comprised Kinesio Taping, Stretching, Ultrasound Therapy, Thermal Agents, and Walking Aids. Conclusions: This clinical practice guideline provides a context-specific, evidence-based framework for Portuguese physiotherapists managing knee osteoarthritis. By bridging international evidence with local clinical practice, the guideline aims to facilitate optimal patient care and inform future research and guideline updates.<\/jats:p>","DOI":"10.3390\/osteology5030023","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T13:35:28Z","timestamp":1753191328000},"page":"23","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development of a Clinical Guideline for Managing Knee Osteoarthritis in Portugal: A Physiotherapist-Centered Approach"],"prefix":"10.3390","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1596-9685","authenticated-orcid":false,"given":"Ricardo Maia","family":"Ferreira","sequence":"first","affiliation":[{"name":"Social Sciences, Education and Sport Department, Polytechnic Institute of Maia, N2i, 4475-690 Maia, Portugal"},{"name":"Physiotherapy Department, Coimbra Health School, Polytechnic University of Coimbra, Rua da Miseric\u00f3rdia, Lagar dos Corti\u00e7os, S. Martinho do Bispo, 3045-093 Coimbra, Portugal"},{"name":"Sport Physical Activity and Health Research & Innovation Center (SPRINT), Rua Escola Industrial e Comercial Nun\u2019\u00c1lvares, 4900-347 Viana do Castelo, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6118-0338","authenticated-orcid":false,"given":"Rui Soles","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Physiotherapy Department, Coimbra Health School, Polytechnic University of Coimbra, Rua da Miseric\u00f3rdia, Lagar dos Corti\u00e7os, S. Martinho do Bispo, 3045-093 Coimbra, Portugal"},{"name":"Health & Technology Research Center (H&TRC), Coimbra Health School, Polytechnic University of Coimbra, Rua 5 de Outubro, 3045-043 Coimbra, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.rdc.2012.10.004","article-title":"Epidemiology of Osteoarthritis","volume":"39","author":"Neogi","year":"2013","journal-title":"Rheum. Dis. Clin. N. 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