Exercise Therapy for Knee Osteoarthritis: A Systematic Review and Network Meta-analysis

Area of Science:

• Orthopedics
• Rehabilitation Medicine
• Sports Science

Background:

• Exercise is a key non-drug treatment for knee osteoarthritis (KOA).
• Identifying the optimal exercise type is crucial for managing KOA symptoms.
• This study systematically reviews exercise interventions for KOA.

Purpose of the Study:

• To determine the most effective exercise therapy for knee osteoarthritis (KOA).
• To compare the efficacy of different exercise types on pain, stiffness, joint function, and quality of life in KOA patients.

Main Methods:

• A systematic review and network meta-analysis of randomized controlled trials (RCTs) were conducted.
• Searched major databases (PubMed, Web of Science, Embase, Cochrane Library) up to April 2022.
• Evaluated aquatic exercise (AE), stationary cycling (CY), resistance training (RT), traditional exercise (TC), and yoga (YG) against control groups using WOMAC, 6-MWT, VAS, and KOOS scores.

Main Results:

• 39 studies with 2646 participants were included, noting a high risk of performance bias.
• All exercise types significantly improved KOA symptoms compared to controls.
• Stationary cycling (CY) and yoga (YG) showed the most significant improvements in pain and function, respectively.

Conclusions:

• Aquatic exercise (AE) and yoga (YG) demonstrate superior efficacy in managing knee osteoarthritis (KOA) symptoms.
• AE is particularly effective for pain relief, while YG excels in improving stiffness, function, and quality of life.
• Resistance training (RT), stationary cycling (CY), and traditional exercise (TC) also offer benefits for KOA management.