Knee joint proprioception in aging, osteoarthritis, and postoperative orthopedic rehabilitation: Current evidence and future directions—a narrative review

Table 2 Evidence summary for major intervention questions in knee proprioceptive rehabilitation

Ref.	Population and evidence source	Intervention	Comparator	Primary/main outcomes1	Follow-up/assessment timing	Principal findings	Principal limitations
Wang et al[8], 2021	Knee osteoarthritis; 24 RCTs; 1275 participants	Proprioceptive training alone or added to other exercise or physiotherapy	No intervention, non-proprioceptive exercise, or conventional physiotherapy	Primary: Pain, stiffness, physical function. Secondary: JPS, strength, mobility, ROM, balance	Reported assessment/follow-up: 2-52 weeks. Interventions: 2-16 weeks	Benefits depended on the comparator. Improvements over no intervention were broader; superiority over active exercise was less consistent. JPS improved across several comparisons	Methodological weaknesses; heterogeneous interventions; limited subgroup analyses; only two studies assessed outcomes at one year
Lin et al[14], 2025	Knee osteoarthritis; 22 RCTs	Proprioceptive, sensorimotor, or related exercise, alone or as an adjunct	Conventional physiotherapy, other exercise, or control activities	TUG; WOMAC total and subscales; NRS/VAS pain	Assessment timing varied. Most interventions lasted ≤ 8 weeks; longest intervention: 12 months. A distinct post-treatment follow-up range was not summarized	Improved TUG and WOMAC total scores; no significant pooled improvements in individual WOMAC pain, stiffness, or function subscales. Pain findings varied by measure and intervention duration	Low-certainty evidence; risk-of-bias concerns; heterogeneous programs and comparators; uncertain persistence of benefits after treatment
Chen et al[10], 2025	After ACLR; 13 RCTs; 529 participants	Proprioceptive, balance, neuromuscular, aquatic, or neurocognitive training	Conventional rehabilitation	Subjective knee function; single-leg hop performance; proprioception; ROM; knee flexion strength	Postoperative assessment timing varied; no consolidated post-treatment follow-up range was provided	Improved subjective function, hop performance, and pooled proprioceptive outcomes; no significant effects on ROM or knee flexion strength	Heterogeneous training and postoperative stages; differing proprioceptive measures, including balance/stability indices; limited evidence on sustained effects
Domínguez-Navarro et al[46], 2018	Hip or knee replacement; postoperative benefits identified after knee replacement 8 trials; 567 participants	Balance/proprioceptive training added to conventional care	Conventional care	Primary: Self-reported function and balance. Additional: Knee function, pain, falls, quality of life	Short- and mid-term assessments; timing differed across trials	Improved balance and self-reported function after knee replacement; balance benefits persisted at mid-term. Preoperative training did not improve outcomes after hip replacement	Small evidence base; differing procedures, intervention timing, and outcome measures; limited support for hip-specific and preoperative effects
Ma et al[15], 2022	After arthroscopic partial meniscectomy; 9 RCTs; 453 participants	Proprioceptive/balance/neuromuscular training, usually added to conventional rehabilitation	Conventional rehabilitation; some trials used no-intervention controls	Proprioception; knee flexor/extensor strength; knee function scores	Mainly end-of-treatment assessments after 8-12-week programs; mid- and long-term efficacy insufficiently assessed	Potential improvements in proprioception and strength; functional recovery findings require cautious interpretation	Very low-certainty evidence; small studies; inconsistent intervention initiation and control conditions; limited blinding and follow-up

¹Outcomes are identified as primary only where explicitly designated by the review; otherwise, the main assessed outcomes are listed. Intervention duration is distinguished from post-treatment follow-up. Limitations and certainty statements reflect the cited reviews; no independent evidence grading was performed for this narrative review.

RCT: Randomized controlled trial; ACLR: Anterior cruciate ligament reconstruction; JPS: Joint position sense; ROM: Range of motion; TUG: Timed Up and Go; WOMAC: Western Ontario and McMaster Universities Osteoarthritis Index; NRS: Numerical Rating Scale; VAS: Visual Analog Scale.