Evidence of Improvement in Various Impairments by Exercise Interventions in Patients with Knee Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Clinical Trials

Abstract

ABSTRACT. Purpose: To investigate improvement in various impairments by exercise interventions in patients with knee osteoarthritis (OA). Methods: We collected data on randomized controlled trials (RCTs) comparing the effects of exercise intervention with those of either nonintervention or psychoeducational intervention in patients with knee OA. Data on pain, stiffness, muscle strength, range of motion, fl exibility, maximal oxygen uptake, and position sense were synthesized. The Grading of Recommendations Assessment, Development, and Evaluation system was used to determine the quality of the evidence. Results: Thirty-three RCTs involving 3,192 participants were identifi ed. Meta-analysis provided highquality evidence that exercise intervention improves maximal oxygen uptake, and moderate-quality evidence that exercise intervention also improves pain, stiffness, knee extensor and fl exor muscle strength, and position sense. The evidence that exercise intervention improves knee extension and fl exion range of motion was deemed as undetermined-quality. Conclusion: In patients with knee OA, improvement in pain, stiffness, muscle strength, maximal oxygen uptake, and position sense with the use of exercise intervention can be expected. Although the quality of evidence of the effect of exercise intervention on range of motion was inconclusive, exercise intervention should be recommended for patients with knee OA to improve various impairments.

Efficacy and Safety of Massage for Osteoarthritis of the Knee: a Randomized Clinical Trial

“…Effect sizes were large in the present study and were comparable to, or superior to, those seen in other trials conducted using non-pharmacological approaches in patients with knee osteoarthritis. 19,[32][33][34][35][36][37][38][39] Massage does not carry the adverse effects of many pharmacologic and invasive treatments. 6,7,12,40,41 While osteoarthritis treatment guidelines favor pharmacotherapy, 42 preferred treatments like NSAIDs and acetaminophen are frequently overused, increasing the risk of adverse effects such as gastrointestinal, cardiac, and renal complications.…”

Improving Postoperative Care Through Mindfulness-Based and Isometric Exercise Training Interventions: Systematic Review

“…Numerous postoperative interventions have been tested in different clinical settings designed to maximize recovery or functioning, alleviate pain, prevent joint stiffness and muscular atrophy, and improve mental capabilities and coordination [ 4 , 5 ]. Recently, two intervention types have grown in popularity: mindfulness-based cognitive therapy (MBCT) [ 6 ] and isometric exercise training (IET) interventions [ 7 ].…”

“…IET is performed by increasing muscle tension while preventing joint motion, most often by providing unmoving resistance during an exercise [ 11 ]. A meta-analysis/systematic review of 33 randomized controlled trials showed that exercise interventions can improve pain, stiffness, muscle strength, maximal oxygen uptake, and position sense (awareness) [ 7 ]. Previous research also shows that breast cancer patients who participated in a brief IET intervention showed alterations in tumor tissue gene expression [ 12 ], suggesting that exercise may have direct effects on biological mechanisms associated with cancer development and progression.…”

Effectiveness of Isometric Exercise and Counseling on Level of Pain Among Patients With Knee Osteoarthritis

“…The results of the meta-analysis also reported that the exercise reduced the BP in pregnancy by 9%. Furthermore, the exercise prevented new episodes of sick leave due to lumbo-pelvic pain ( Tanaka et al., 2013 ).…”