According to studies published in The Lancet Rheumatology, people with hip or knee osteoarthritis (OA) who exercise fare better than patients who do not, thereby corroborating the positive effect of therapeutic exercise on pain and physical function.
Dr. Holden and colleagues performed a systematic review and meta-analysis to evaluate individual patient-level moderators on the effects of exercise on pain and physical function in patients with knee /hip OA, or both. They analyzed randomized controlled trials (RCTs) in which the effects of exercise were contrasted with those of no exercise or activity-free control methods of intervention. Data from 31 randomized controlled trials totaling 4,241 people were analyzed. Therapeutic exercise reduced pain by -6.36 points in the short term, -3.77 points in the middle, and -3.43 points in the long term, according to a standardized scale with 100 signifying the worst pain. The comparable changes for physical function scores were 4.46 points in the short term, -2.71 points in the middle, and -3.39 points in the long term. The researchers also found that the effects of exercise were tempered by baseline pain and physical function. Researchers found that patients who reported more pain and better physical function at baseline showed more benefits from exercise than patients who reported less pain and better physical function. When compared to non-exercise controls, there was evidence that therapeutic exercise had a minor, overall favorable impact on pain and physical function. The researchers found that overall, as compared to the non-exercise control group, those who engaged in therapeutic exercise showed reduced pain throughout the short, medium, and long terms.
A 2020 systematic review analyzed the evidence on the effect of therapeutic exercise on knee and hip OA patients from RCTs. Experts denoted that therapeutic exercise may be helpful in lowering pain in those with neutral alignment and knee OA, but not in those with varus malalignment. They reported that 14 RCTs examined 23 potential moderators in 13 RCTs on knee OA (n = 2743) and 6 potential moderators in 1 RCT on hip OA (n = 203). The quality of the subgroup analysis varied. In one RCT, only knee varus malalignment (WOMAC-pain adjusted differential 12.7 in the neutral alignment sub-group and 1.8 in the malaligned sub-group, interaction term: P =0.02) was a moderator of therapeutic exercise compared to the no-exercise control group. Experts reported that obesity, knee laxity/instability, heart issues, and Varus thrust all tempered the impact of therapeutic exercise on pain or function compared to different comparison exercises.
According to another study published in Arthritis Research & Therapy, patients with knee osteoarthritis showed enhanced cartilage degradation and tissue turnover after a 3-month, exercise-related joint loading training program.
The study findings emphasize that tailored exercise interventions can lead to significant and sustained improvements in both pain management and physical function.
To learn more about the effect of exercise on knee OA, read our previous news on, ‘Study finds increased cartilage tissue turnover in knee osteoarthritis patients after intensity exercise-training‘.
References
- Holden MA, Hattle M, Runhaar J, Riley RD, Healey EL, Quicke J, et al. Moderators of the effect of therapeutic exercise for knee and hip osteoarthritis: a systematic review and individual participant data meta-analysis. The Lancet Rheumatology. 2023 Jun 12.
- Quicke JG, Runhaar J, Van der Windt DA, Healey EL, Foster NE, Holden MA. Moderators of the effects of therapeutic exercise for people with knee and hip osteoarthritis: a systematic review of sub-group analyses from randomised controlled trials. Osteoarthritis and Cartilage Open. 2020 Dec 1;2(4):100113.