Land-based exercise for osteoarthritis of the knee: a metaanalysis of randomized controlled trials.

Fransen M, McConnell S.

The objectives of this study was to determine if clinical guidelines recommending therapeutic exercise for people with knee osteoarthritis (OA) are supported by rigorous scientific evidence and to explore whether the magnitude of treatment benefit reported in randomized controlled trials (RCT) is associated with exercise dosage or study methodology. The 32 included studies provided data on almost 3800 participants. Metaanalysis revealed a beneficial treatment effect for knee pain and for physical function. While the pooled beneficial effects of the 9 RCT evaluating exercise programs providing fewer than 12 direct supervision occasions or the 9 RCT judged to have a low risk of bias remained significant and clinically relevant, the magnitude of treatment benefit pooled from these RCT was significantly smaller than the comparator group. The mode of treatment delivery (individual treatments, exercise classes, home program) was not significantly associated with the magnitude of treatment benefit.

The authors concluded that there is evidence that land-based therapeutic exercise has at least short-term benefit in terms of reduced knee pain and physical disability for people with knee OA

J Rheumatol. 2009 Jun;36(6):1109-17.

Link to abstract