Long-Term effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: A systematic review (original) (raw)
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Arthritis & Rheumatism, 1999
Methods. A computerized literature search of Medline, Embase, and Cinahl was carried out. Randomized clinical trials on exercise therapy for OA of the hip or knee were selected if treatment had been randomly allocated and if pain, self-reported disability, observed disability, or patient's global assessment of effect had been used as outcome measures. The validity of trials was systematically assessed by independent reviewers. Effect sizes and power estimates were calculated. A best evidence synthesis was conducted, weighting the studies with respect to their validity and power.
Effectiveness of exercise in patients with osteoarthritis of hip or knee: nine months' follow up
Annals of the Rheumatic Diseases, 2001
Objective-To determine whether the effects of an exercise programme in patients with osteoarthritis of hip or knee are sustained at six and nine months' follow up. Methods-A randomised, single blind, clinical trial was conducted in a primary care setting. Patients with osteoarthritis of hip or knee (ACR criteria) were selected. Two intervention groups were compared. Both groups received treatment from their general practitioner, including patient education and drug treatment if necessary. The experimental group also received exercise treatment from a physiotherapist in primary care. The treatment period was 12 weeks, with an ensuing 24 week follow up. The main outcome measures were pain, drug use (non-steroidal anti-inflammatory drugs), and observed disability. Results-201 patients were randomly allocated to the exercise or control group, and 183 patients completed the trial. At 24 weeks exercise treatment was associated with a small to moderate eVect on pain during the past week (diVerence in change between the two groups −11.5 (95% CI −19.7 to −3.3). At 36 weeks no diVerences were found between the groups. Conclusions-Beneficial eVects of exercise decline over time and finally disappear.
Exercise therapy for the management of osteoarthritis of the hip joint: a systematic review
Arthritis Research & Therapy, 2009
Introduction Recent guidelines pertaining to exercise for individuals with osteoarthritis have been released. These guidelines have been based primarily on studies of knee-joint osteoarthritis. The current study was focused on the hip joint, which has different biomechanical features and risk factors for osteoarthritis and has received much less attention in the literature. The purpose was to conduct a systematic review of the literature to evaluate the exercise programs used in intervention studies focused solely on hip-joint osteoarthritis, to decide whether their exercise regimens met the new guidelines, and to determine the level of support for exercise-therapy interventions in the management of hip-joint osteoarthritis.
Journal of Bodywork and Movement Therapies, 2017
Background & Aims: There is no consensus regarding what type of exercises, combination of exercises or exercise dosage is most effective in patients with longterm hip arthrosis. The goal of this study was to evaluate the effects of two different exercise programs related to dose-response relationships. Method: Prospective randomized controlled clinical trial with 6 months follow where 33 participants were randomly assigned to either high repetitive, high dosage medical exercise therapy (MET) (n=16) or low dosage exercise therapy (ET) (n=17). Primary outcomes are pain using a visual analogue scale (VAS) and function using a functional assessment questionnaire (WOMAC). Results: Patients were equal at baseline. Two patients (6 %) dropped out during the treatment period. There were no difference between groups after end of treatment nor at 6 months follow up. However, there were significant differences within each exercise group at end of treatment. Conclusion: In this pilot study, we were not able to show any difference between MET and ET. More research is needed with a larger patient population and a more extensive exercise period similar to other studies that are published regarding dose-response effects.
Osteoarthritis and cartilage open, 2020
Objective: 1) To identify potential moderators of the effect of therapeutic exercise explored in randomised controlled trials (RCTs) of knee and hip osteoarthritis (OA); 2) summarise the extent, strength and quality of evidence reported for moderators. Design: Systematic review (PROSPERO CRD42019148074). Inclusion criteria: a) RCTs with subgroup analyses investigating potential moderator variables; b) participants with knee and/or hip OA; c) therapeutic exercise interventions compared to either no exercise control or alternative exercise intervention(s), and; d) measuring pain or physical function outcomes. Included RCTs' risk of bias and subgroup analysis quality were assessed. Data were extracted on subgroup analyses (methods and potential moderators), outcomes (pain and function) and subgroup findings (associated statistics of potential moderator*intervention effects). Findings were analysed using narrative synthesis. Results: 14 RCTs were included; 13 knee OA RCTs (n ¼ 2743 participants) explored 23 potential moderators and 1 hip OA RCT (n ¼ 203) explored 6 potential moderators. Subgroup analysis quality was mixed. Knee varus malalignment was the only moderator of therapeutic exercise compared to non-exercise control in 1 RCT (WOMAC-pain adjusted difference 12.7 in the neutral alignment subgroup and 1.8 in the malaligned subgroup , interaction term: p ¼ 0.02). Varus thrust, knee laxity/instability, obesity and cardiac problems all moderated the effect of therapeutic exercise on pain or function compared to different comparison exercise. Conclusions: Therapeutic exercise may be effective for reducing pain in people with knee OA and neutral alignment but not for those with varus malalignment. The exercise moderator literature is limited. More robust evidence is required to inform subgroup exercise selection.
BMJ Open, 2018
Introduction Osteoarthritis (OA) of the knee is characterised by knee pain, disability and degenerative changes, and places a burden on societies all over the world. Exercise therapy is an often-used modality, but there is little evidence of what type of exercise dose is the most effective, indicating a need for controlled studies of the effect of different dosages. Thus, the aim of the study described in this protocol is to evaluate the effects of high-dose versus low-dose medical exercise therapy (MET) in patients with knee OA. Methods and analysis This is a multicentre prospective randomised two-arm trial with blinded assessment and data analysis. We are planning to include 200 patients aged 45–85 years with symptomatic (pain and decreased functioning) and X-ray verified diagnosis of knee OA. Those eligible for participation will be randomly allocated to either high-dose (n=100) or low-dose (n=100) MET. All patients receive three supervised treatments each week for 12 weeks, givi...
Effect of Exercise in Management of Knee Osteoarthritis: A Systematic Review
Background: Osteoarthritis is considered commonest cause of disability in elder adults. The knee is the joint most frequently affected by osteoarthritis. Clinically, knee OA is described by pain at weight bearing, soreness, knee movement restriction, crepitation, swelling, edema and inflammation. Physiotherapy as the main choice of conservative management; which includes various strategies such as manual therapy, exercises, patellar taping and electrical modalities with or without thermal modalities as measures for pain reduction. Aim: To determine the recent research evidences for the efficacy of exercise in knee osteoarthritis patients. Method: This systematic review mainly includes randomized controlled trails. Searching done by Google Scholar, PubMed and PEDro from 2012 to 2021. We used terms like-knee pain, osteoarthritis, exercise and physiotherapy management. Result: Present outcomes shows that exercise therapy is effective technique in reducing pain in Knee osteoarthritis patients without adverse effects. The search resulted in 50 articles but only 05 articles were selected for the study based on criteria. Conclusion: Therapeutic exercise program designed for knee OA treatment can be more effective at increasing quadriceps muscle activation by reducing pain during exercise.
The effect of exercise therapy on knee osteoarthritis: a randomized clinical trial
Medical journal of the Islamic Republic of Iran, 2015
Knee osteoarthritis (OA) is the most common musculoskeletal disease among old individuals which affects ability for sitting on the chair, standing, walking and climbing stairs. Our objective was to investigate the short and long-term effects of the most simple and the least expensive exercise protocols in combination to conventional conservative therapy for knee OA. It was a single blind RCT study with a 12-months follow-up. Totally, 56 patients with knee OA were assigned into 2 random groups. The patients in exercise group received exercise for knee muscles in combination with non-steroid anti-inflammatory drugs (NSAIDs) and 10 sessions acupuncture and physiotherapy modalities. Non-exercise group received similar treatments except exercise program. The changes in patients' pain and functional status were evaluated by visual analog scale (VAS), knee and osteoarthritis outcome score (KOOS) questionnaire and functional tests (4 steps, 5 sit up, and 6 min walk test) before and afte...