Ottawa Panel Evidence-Based Clinical Practice Guidelines for Electrotherapy and Thermotherapy Interventions in the Management of Rheumatoid Arthritis in Adults.

BACKGROUND AND PURPOSE: The purpose of this project was to create guidelines for electrotherapy and thermotherapy interventions in the management of adult patients (>18 years of age) with a diagnosis of rheumatoid arthritis according to the criteria of the American Rheumatism Association (1987).

METHODS: Using Cochrane Collaboration methods, the Ottawa Methods Group identified and synthesized evidence from comparative controlled trials. The group then formed an expert panel, which developed a set of criteria for grading the strength of the evidence and the recommendation. Patient-important outcomes were determined through consensus, provided that these outcomes were assessed with a validated and reliable scale.

RESULTS: The Ottawa Panel developed 8 positive recommendations of clinical benefit. Lack of evidence meant that the panel could not gauge the efficacy of electrical stimulation.

DISCUSSION AND CONCLUSION: The Ottawa Panel recommends the use of low-level laser therapy, therapeutic ultrasound, thermotherapy, electrical stimulation, and transcutaneous electrical nerve stimulation for the management of rheumatoid arthritis.