Osteoarthritis Exercise Interventions for a Younger Adult Population-A Narrative Review

Osteoarthritis (OA) is considered to be a condition attributable to ageing; however, symptoms can start under 45 years old in one-fifth of patients. Exercise therapy is recommended as first-line treatment in all OA guidance; however, uncertainty remains regarding optimal exercise programmes (including strength, aerobic or mind-body interventions) as different populations might respond better to one intervention than another. This review aims to understand the evidence surrounding exercise interventions for OA in younger adults (18-50 years old). An umbrella review methodology was adopted. Individual studies included in 50 systematic reviews (±meta-analyses) published in the last decade were reviewed and those involving participants aged 18-50 were selected. Five papers, from a potential 1046, involved appropriate participants and underwent full-text review. Two were excluded due to pathology and language; therefore, three studies with 265 participants were included. Exercise interventions included strength-based, neuromuscular control and aerobic and were delivered under supervision or via sensor or virtual reality technology. Interventions improved pain, functional, cartilage composition and inflammatory outcomes measures; however, study heterogeneity prevented direct comparison and meta-analysis. There is a clear bias in the literature for an older population, with research and clinical interventions required for a younger adult population with, or at risk of, OA.