+AA
Fr
Back
Evidence Summary

What is an Evidence Summary?

Key messages from scientific research that's ready to be acted on

Got It, Hide this
  • Rating:

In people who have knee osteoarthritis, therapeutic exercise programs reduce pain and improve physical functioning for up to 6 months after the end of the program

Fransen M, McConnell S, Harmer AR, et al. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2015;1:CD004376.

Review question

In people who have knee osteoarthritis, do therapeutic exercise programs done on land reduce pain or improve physical functioning or quality of life?

Background

Osteoarthritis is the most common form of arthritis. It is a disease of the joints and often occurs in knees. It develops when your joints lose the cartilage that protects the ends of your bones. There is no cure, and it often gets worse over time. People with osteoarthritis can have pain, tenderness, joint stiffness, and worsening physical functioning.

There are various treatments for the symptoms of knee osteoarthritis. This review is about therapeutic exercise programs, which use physical activities to achieve specific aims (e.g., strengthen muscles, improve how well a joint moves).

How the review was done

The researchers did a systematic review, searching for studies that were published in English up to May 2013.

They found 54 randomized or nonrandomized controlled trials with 6,345 people (mean age 53 to 75 years, 42% to 100% women).

The key features of the trials were:

  • people were adults with knee osteoarthritis;
  • treatments were therapeutic exercise programs done on land (rather than in the water) and included one or more types of exercise (e.g., exercises to strengthen lower limbs or quadriceps muscles, aerobics, walking, or other forms of exercise);
  • exercise programs could be done one-on-one or in classes or groups and at home or in another location;
  • exercise programs were compared with no treatment or other non-exercise treatments; and
  • exercise programs done around the time of surgery were excluded.

What the researchers found

Compared with no exercise program, land-based therapeutic exercise programs:

  • reduced pain and improved physical functioning and quality of life immediately after the end of the program;
  • reduced pain and improved physical functioning 2 to 6 months after the end of the program; and
  • reduced pain and improved physical functioning at more than 6 months after the end of the program.

Conclusion

In people who have knee osteoarthritis, therapeutic exercise programs done on land reduce pain and improve physical functioning up to 6 months after the end of the program.

Therapeutic exercise program vs no exercise program in people with knee osteoarthritis

Outcomes

When outcomes were assessed

Number of trials (and people)

Effects of exercise

Pain

Immediately after exercise program

44 trials (3,537 people)

Equal to about a 12-point improvement out of 100 (from as few as 10 to as many as 15 points).

For every 4 people taking part in an exercise program, 1 additional person will have less pain (for as few as 3 to as many as 5 people taking part in an exercise program).

 

2 to 6 months after exercise program

12 trials (1,468 people)

Equal to about a 6-point improvement out of 100 (from as few as 3 to as many as 9 points)

 

More than 6 months after exercise program

8 trials (1,272 people)

Equal to about a 13-point improvement out of 100 (from as few as 1 to as many as 25 points)*

Physical functioning

Immediately after exercise program

44 trials (3,913 people)

Equal to about a 10-point improvement out of 100 (from as few as 8 to as many as 13 points).

For every 4 people taking part in an exercise program, 1 additional person will have improved physical functioning (for as few as 3 to as many as 5 people taking part in an exercise program).

 

2 to 6 months after exercise program

10 trials (1,279 people)

Equal to about a 3-point improvement out of 100 (from as few as 1 to as many as 5 points)

 

More than 6 months after exercise program

8 trials (1,266 people)

Equal to about an 11-point improvement out of 100 (from as few as 2 to as many as 21 points)*

Quality of life

Immediately after exercise program

13 trials (1,073 people)

Equal to about a 4-point improvement out of 100 (from as few as 2 to as many as 5 points).

For every 8 people taking part in an exercise program, 1 additional person will have improved quality of life (for as few as 5 to as many as 14 people taking part in an exercise program)

*Calculated using information provided in the review. When 2 trials with very different results were excluded from the analyses, exercise programs improved physical functioning, but not pain, at more than 6 months after the end of the program.




Glossary

Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.

Related Web Resources

DISCLAIMER These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Register for free access to all Professional content

Register
Want the latest in aging research? Sign up for our email alerts.
Subscribe
© 2012 - 2019 McMaster University | 1280 Main Street West | Hamilton, Ontario L8S4L8 | +1 905-525-9140 | Terms Of Use