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Cochrane Database of Systematic Reviews

Exercise for osteoarthritis of the knee

Overview of attention for article published in this source, October 2008
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Exercise for osteoarthritis of the knee
Published by
John Wiley & Sons, Ltd, October 2008
DOI 10.1002/14651858.cd004376.pub2
Pubmed ID

Fransen, Marlene, McConnell, Sara


Biomechanical factors, such as reduced muscle strength and joint malalignment, have an important role in the initiation and progression of knee osteoarthritis (OA). Currently, there is no known cure for OA; however, disease-related factors, such as impaired muscle function and reduced fitness, are potentially amenable to therapeutic exercise. To determine whether land-based therapeutic exercise is beneficial for people with knee OA in terms of reduced joint pain or improved physical function. Five electronic databases were searched, up until December 2007. All randomized controlled trials randomising individuals and comparing some form of land-based therapeutic exercise (as opposed to exercises conducted in the water) with a non-exercise group. Two review authors independently extracted data and assessed methodological quality. All analyses were conducted on continuous outcomes. The 32 included studies provided data on 3616 participants for knee pain and 3719 participants for self-reported physical function. Meta-analysis revealed a beneficial treatment effect with a standardized mean difference (SMD) of 0.40 (95% confidence interval (CI) 0.30 to 0.50) for pain; and SMD 0.37 (95% CI 0.25 to 0.49) for physical function. There was marked variability across the included studies in participants recruited, symptom duration, exercise interventions assessed and important aspects of study methodology. The results were sensitive to the number of direct supervision occasions provided and various aspects of study methodology. While the pooled beneficial effects of exercise programs providing less than 12 direct supervision occasions or studies utilising more rigorous methodologies remained significant and clinically relevant, between study heterogeneity remained marked and the magnitude of the treatment effect of these studies would be considered small. There is platinum level evidence that land-based therapeutic exercise has at least short term benefit in terms of reduced knee pain and improved physical function for people with knee OA. The magnitude of the treatment effect would be considered small, but comparable to estimates reported for non-steroidal anti-inflammatory drugs.

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Mendeley readers

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Geographical breakdown

Country Count As %
Brazil 2 1%
United Kingdom 2 1%
Sweden 1 <1%
Denmark 1 <1%
Japan 1 <1%
Unknown 166 96%

Demographic breakdown

Readers by professional status Count As %
Student > Master 27 16%
Student > Bachelor 26 15%
Researcher 17 10%
Student > Ph. D. Student 15 9%
Student > Doctoral Student 13 8%
Other 37 21%
Unknown 38 22%
Readers by discipline Count As %
Medicine and Dentistry 64 37%
Nursing and Health Professions 26 15%
Sports and Recreations 11 6%
Agricultural and Biological Sciences 5 3%
Social Sciences 4 2%
Other 17 10%
Unknown 46 27%