Effect of exercise and/or educational interventions on physical activity and pain in patients with hip/knee osteoarthritis: A systematic review with meta-analysis

Abstract

Objective To investigate the effectiveness of exercise and/or educational intervention on physical activity and pain in patients with hip/knee osteoarthritis (OA) using systematic review and meta-analysis. Methods We searched randomized controlled trials that investigated physical activity and pain and compared exercise and/or educational intervention with usual care in patients with hip/knee OA in MEDLINE (PubMed), ProQuest, Scopus, and the Physiotherapy Evidence Database (PEDro), including all those published by April 30, 2022 and written in English. Studies that newly applied analgesics after onset of the intervention were excluded. The revised Cochrane risk-of-bias tool for randomized trials was used to assess the methodological qualities. The random-effects model was used for meta-analysis with standard mean differences using RevMan version 5.4. The body of evidence for each study was synthesized using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Results Twenty studies including 2,350 patients were included (7 exercise studies, 8 educational intervention studies and 5 combination studies). The meta-analysis demonstrated that there is very low evidence that combination therapy of exercise and educational intervention improve the physical activity level at the endpoint (4 articles; SMD 0.33, 95% CI 0.04 to 0.51, P = 0.03). Low evidence was observed for combination therapy reducing pain (4 articles; SMD -0.15, 95% CI -0.29 to -0.02, P = 0.03). Discussion The current evidence indicated that combination therapy of exercise and educational intervention leads to improved physical activity and pain reduction in hip/knee OA patients, but the risk of bias in each study, especially in allocation concealment, downgraded the evidence level. These findings support the use of a combination therapy of exercise and educational intervention to promote physical activity levels in patients with hip/knee OA. Trail registration There was no financial support for this research. The protocol was registered at the International Prospective Register of Systematic Reviews (registration code: CRD42020205804).

Follow-up of individualised physical activity on prescription and individualised advice in patients with hip or knee osteoarthritis: A randomised controlled trial

“…37 In addition, the information about health consequences behavioural change technique should be combined with a physical activity intervention. 38 Feedback was mainly obtained from the results of the performance-based tests of function, which resemble daily activities and are easy to understand, and probably motivated the patients to continue with their chosen activities. 26,29 Feedback was in a meta-analysis reported to be the most important behaviour change technique for maintaining long-term physical activity (≥12 months) in adults.…”

Effectiveness of an educational approach between adolescents and adults with patellofemoral pain syndrome: a scoping review with meta-analysis

“…Sasaki et al 37 ) suggested that a combination of education and exercise leads to improved physical activity and pain reduction in hip/knee osteoarthritis patients. Education for patients diagnosed with osteoarthritis includes offering accurate verbal and written information to all people with osteoarthritis to enhance understanding of the condition and its management and to counter misconceptions, such as that it inevitably progresses and cannot be treated.…”

TMF suppresses chondrocyte hypertrophy in osteoarthritic cartilage by mediating the FOXO3a/BMPER pathway

“…Rats were anesthetized with 3% sodium pentobarbitone (40 mg/kg) via an intraperitoneal injection (i.p.). After routine shaving and disinfection in the right knee, 10 µl of sterile saline with 1 mg of monosodium iodoacetate (MIA; Sigma-Aldrich; Merck KGaA) was intra-articularly injected (23). Rats in the negative control group received the same volume of vehicle.…”