Implementation of best-evidence rehabilitation for hip, knee and hand osteoarthritis in Africa: A cause for concern.

Importance: Evidence-based practice recommendations and guidelines highlight the benefits of exercise, physical activity, weight management, and education for self-management, which are effective in the management of osteoarthritis (OA). However, the uptake among African health professionals remain poor. The objective of this commentary is to highlight the disparity between current best-evidence rehabilitation practices and African health professionals' practices amidst the high prevalence of OA. Observations: The World Health Organization emphasizes the importance of physical activity in light of the rising OA prevalence in the ageing population, with the burden of comorbid disease negatively impacting the ageing population's quality of life. The concern is that even though the physical activity directive from the World Health Organisation clearly outlines the physical activity targets and best-evidence recommendations and guidelines for managing patients with OA, African health professionals' uptake remain low, potentially to the disadvantage of patients. Conclusions and relevance: Increasing OA prevalence with subpar rehabilitation may result in lower quality of life and function for individuals diagnosed with hip, knee, hand and other joint OA, leading to a substantial financial burden on the individual, family, community, stakeholders and governmental levels. Development of African context-specific evidence-based rehabilitation guidelines and improved training on current guidelines by universities and professional societies are needed. Policy makers prioritizing OA as a pertinent burden of disease is lacking in Africa. A multidisciplinary team approach is needed where early referral to physiotherapists is emphasized.