Studies of exercise in patients with known knee OA
| STUDY | STUDY TYPE | INTERVENTION | OUTCOME IN KNEE OA | COMMENTS |
|---|---|---|---|---|
| Bartels et al,47 2007 | Cochrane review | Aquatic exercise | Pain—large reduction; function—small to moderate benefit; quality of life—small to moderate benefit | Combined hip and knee study 800 participants Lack of many high-quality studies Short-term follow-up of outcomes |
| Fransen and McConnell,48 2008 | Cochrane review | Land-based exercise | Pain—small reduction; physical function—small benefit | Generally good-quality evidence 3616 participants Outcomes sensitive to degree of supervision of exercise Short-term follow-up Improvement similar to effect of NSAIDs |
| Latham et al,49 2008 | Cochrane review | Progressive resistance training | Pain—small reduction; functional limitation—moderate benefit; disability—no effect | Problems with control matching and intention-to-treat analysis 3783 participants More increase in strength than aerobic capacity Adverse effects poorly reported |
| Jamtvedt et al,50 2007 | Systematic review of systematic reviews | All physical therapies | Good-quality evidence that exercise and weight reduction improve both pain scores and physical function | Range of modalities studied 9 systematic reviews of 49 trials of exercise therapy Weight-reduction trials included behaviour therapy and 1 good systematic review containing 4 trials |
| Vignon,51 2006 | Systematic review | Activities of living, sports, exercise habits, occupational activities | Pain—good evidence for structured activity in sedentary participants; benefit of dynamic over static exercise; trauma and obesity contribute more risk than sports; exercise at a pain-free level is safe | Wider ranging modalities lead to increased heterogeneity |
| Roddy et al,52 2005 | Systematic review | Aerobic exercise, quadriceps strengthening | Pain—4 exercise and 11 strengthening studies showed improvement; disability—2 exercise and 10 of 11 strengthening studies showed improvement; limited evidence for no difference between exercise or strengthening; adherence to intervention a major predictor of success | Small number of exercise studies Interventions lasted between 8 wk and 2 y |
| Petrella,53 2000 | Systematic review | Walking | Pain—small to moderate benefit; disability—small benefit; global assessment—moderate to large perceived benefit | All short-term outcomes in studies lasted less than 8 wk |
| Pisters et al,54 2007 | Systematic review | Long-term (> 6 mo) follow-up of exercise therapy | Pain—no evidence for improvement; disability—no evidence for improvement; booster sessions provided longer term improvement | Studies included both hip and knee OA |
| Belo et al,55 2007 | Systematic review | Prognostic factors for knee OA prevention | Evidence for definite association between serum hyaluronic acid levels and generalized OA; limited association with running; conflicting association with obesity; unrelated to baseline OA, knee pain, sex, quadriceps strength, injury, and sports participation | Reviewed studies selected for interventions influencing progression—exercise considered to be one of these interventions |
NSAID—nonsteroidal anti-inflammatory drug, OA—osteoarthritis.