Exercise for osteoarthritis of the knee

Area of Science:

• Orthopedics and Sports Medicine
• Rehabilitation Science
• Evidence-Based Practice

Background:

• Knee osteoarthritis (OA) is a prevalent condition causing significant pain and functional limitations.
• Current clinical guidelines recommend self-management through exercise for knee OA.
• This systematic review provides an updated analysis of land-based exercise interventions for knee OA.

Purpose of the Study:

• To evaluate the efficacy of land-based exercise for individuals with knee OA.
• Comparisons included exercise versus placebo/attention control, no treatment/usual care, and exercise as an adjunct to other interventions.

Main Methods:

• A systematic review of randomized controlled trials (RCTs) was conducted.
• Searches included major databases (CENTRAL, MEDLINE, Embase) and trial registries up to January 2024.
• Outcomes assessed were pain, physical function, quality of life, treatment success, adverse events, and withdrawals.

Main Results:

• Low- to moderate-certainty evidence suggests exercise improves pain and physical function in the short-term across all comparison groups.
• Improvements in quality of life were observed when exercise was added to other interventions, but were less consistent otherwise.
• Most trials had a high risk of bias, and the clinical significance of the observed benefits was uncertain compared to minimal important difference thresholds.

Conclusions:

• Land-based exercise likely offers short-term improvements in pain and physical function for knee OA patients.
• The clinical importance of these benefits requires further investigation due to methodological limitations and uncertain effect sizes.
• Future research should focus on reducing bias and clarifying the long-term clinical impact of exercise interventions in knee OA management.