An Exercise Therapists' Guide to Neuromuscular Exercise for People With Knee or Hip Osteoarthritis

BACKGROUND: Neuromuscular exercise is commonly used in knee injury prevention programs and in rehabilitation following knee injury, and can also be used to address functional impairments is middle-aged and older individuals with knee and hip osteoarthritis (OA). CLINICAL QUESTION: What is neuromuscular exercise for OA? Why should clinicians use it? And how? Nine themes of common questions from exercise therapists new to neuromuscular exercise are addressed. KEY RESULTS: Neuromuscular exercise aims to improve sensorimotor control and obtain joint stability. Exercises are mainly performed in weight-bearing positions, involving multiple joints and muscle groups, to resemble activities of daily life using commonly available and inexpensive equipment. Neuromuscular exercise should be adapted to the individual and is preferably delivered under the supervision of a trained and experienced exercise therapist. Neuromuscular exercise is safe in terms of serious adverse events and pain flares, and associated with a positive change in pain, function and quality of life like other types of exercise for OA. CLINICAL APPLICATION: Neuromuscular exercise can be used as an alternative to, or in addition to, aerobic exercise and strength training in individuals with hip and knee OA. J Orthop Sports Phys Ther 2025;55(8):1-9. Epub 18 June 2025. doi:10.2519/jospt.2025.13041.