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Aerobic walking or strengthening exercise for osteoarthritis of the knee? A systematic review.
Ann Rheum Dis. 2005; 64(4):544-8 (ISSN: 0003-4967)
Roddy E; Zhang W; Doherty M
Academic Rheumatology, Nottingham City Hospital, Nottingham NG5 1PB, UK. edward.roddy@nottingham.ac.uk
OBJECTIVE: To compare the efficacy of aerobic walking and home based quadriceps strengthening exercises in patients with knee osteoarthritis. METHODS: The Medline, Pubmed, EMBASE, CINAHL, and PEDro databases and the Cochrane controlled trials register were searched for randomised controlled trials (RCTs) of subjects with knee osteoarthritis comparing aerobic walking or home based quadriceps strengthening exercise with a non-exercise control group. Methodological quality of retrieved RCTs was assessed. Outcome data were abstracted for pain and self reported disability and the effect size calculated for each outcome. RCTs were grouped according to exercise mode and the data pooled using both fixed and random effects models. RESULTS: 35 RCTs were identified, 13 of which met inclusion criteria and provided data suitable for further analysis. Pooled effect sizes for pain were 0.52 for aerobic walking and 0.39 for quadriceps strengthening. For self reported disability, pooled effect sizes were 0.46 for aerobic walking and 0.32 for quadriceps strengthening. CONCLUSIONS: Both aerobic walking and home based quadriceps strengthening exercise reduce pain and disability from knee osteoarthritis but no difference between them was found on indirect comparison.
- PreMedline Identifier: 15769914
Long-term effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: a systematic review.
Arthritis Rheum. 2007; 57(7):1245-53 (ISSN: 0004-3591)
Pisters MF; Veenhof C; van Meeteren NL; Ostelo RW; de Bakker DH; Schellevis FG; Dekker J
Netherlands Institute for Health Services Research, Utrecht, The Netherlands. m.pisters@nivel.nl
OBJECTIVE: To determine the long-term effectiveness (>/=6 months after treatment) of exercise therapy on pain, physical function, and patient global assessment of effectiveness in patients with osteoarthritis (OA) of the hip and/or knee. METHODS: We conducted an extensive literature search in PubMed, EMBase, CINAHL, SciSearch, PEDro, and the Cochrane Central Register of Controlled Trials. Both randomized clinical trials and controlled clinical trials on the long-term effectiveness of exercise therapy were included. The followup assessments were at least 6 months after treatment ended. Methodologic quality was independently assessed by 2 reviewers. Effect estimates were calculated and a best evidence synthesis was performed based on design, methodologic quality, and statistical significance of findings. RESULTS: Five high-quality and 6 low-quality randomized clinical trials were included. Strong evidence was found for no long-term effectiveness on pain and self-reported physical function, moderate evidence for long-term effectiveness on patient global assessment of effectiveness, and conflicting evidence for observed physical function. For exercise programs with additional booster sessions, moderate evidence was found for long-term effectiveness on pain, self-reported physical function, and observed physical function. CONCLUSION: The positive posttreatment effects of exercise therapy on pain and physical function in patients with OA of the hip and/or knee are not sustained in the long term. Long-term effectiveness was only found for patient global assessment of effectiveness. However, additional booster sessions after the treatment period positively influenced maintenance of beneficial posttreatment effects on pain and physical function in the long term.
- PreMedline Identifier: 17907210
Do exercise and self-management interventions benefit patients with osteoarthritis of the knee? A metaanalytic review.
J Rheumatol. 2006; 33(4):744-56 (ISSN: 0315-162X)
Devos-Comby L; Cronan T; Roesch SC
Department of Psychology, San Diego State University, San Diego, California 92182-4611, USA. ldevosco@sciences.sdsu.edu
OBJECTIVE: Osteoarthritis (OA) is the most prevalent health condition among seniors and it causes significant pain and disability. We assessed the influence of patient education and exercise regimens on the well-being of patients with knee OA. METHODS: A metaanalysis was conducted on 16 studies reporting exercise and/or self-management interventions for patients with knee OA. The effects on physical and psychological well-being were assessed immediately after the interventions. RESULTS: Compared to control conditions, exercise regimens led to improvement in physical health (by self-report and direct measures) and in overall impact of OA. Perceived psychological health remained unchanged by the exercise programs. Although the effect sizes for the self-management programs were significant for psychological outcomes and for the overall effect of OA, there was a significant difference between self-management and control groups only in psychological outcomes. CONCLUSION: Overall, both patient education and exercise regimens had a modest, yet clinically important, influence on patients' well-being.
- PreMedline Identifier: 16583478
The value of individual or collective group exercise programs for knee or hip osteoarthritis. Clinical practice recommendations.
Ann Readapt Med Phys. 2007; 50(9):741-6, 734-40 (ISSN: 0168-6054)
Tiffreau V; Mulleman D; Coudeyre E; Lefevre-Colau MM; Revel M; Rannou F
Service de m??decine physique et de r??adaptation, h??pital Swynghedauw, CHRU de Lille, 59035 Lille cedex, France. v-tiffreau@chru-lille.fr
OBJECTIVE: To develop clinical practice guidelines concerning individual and group exercise therapy for knee and/or hip osteoarthritis (OA). METHOD: We used the SOFMER (French Physical Medicine and Rehabilitation Society) methodology, combining systematic literature review, collection of everyday clinical practice, and external review by a multidisciplinary expert panel, to develop the guidelines. RESULTS: Physical exercises are proposed for knee and hip OA. The benefit of individual exercises is low to moderate for pain, strength and ability to walk. The effectiveness is not maintained over time if the individual exercise program is not continued. The benefit of group exercise is also low to moderate for pain, strength, balance and ability to walk. There is no evidence of the superiority of one modality over the other (individual or group). CONCLUSION: More randomised controlled trials with good methodology are needed to compare the effectiveness of individual versus group exercise therapy for knee and hip OA.
- PreMedline Identifier: 17963971