Effectiveness of exercise for osteoarthritis of the knee: A review of the literature

Table 1 Outcomes of systematic reviews and meta-analyses

Investigator	Type of study	Outcomes
van Baar et al[11](1999)	Systematic review	Evidence of beneficial effects of exercise therapy in patients with OA of the hip or knee. Effect sizes indicated small-to-moderate beneficial effects of exercise therapy on pain, small beneficial effects on disability outcome measures and moderate-to-great beneficial effects, according to patients’ global assessment of effect
Fransen et al[12](2002)	Systematic review	Land-based therapeutic exercise was shown to reduce pain and improve physical function for people with OA of the knee. SMD (95% CI) was 0.46 (0.35, 0.57) for pain and 0.33 (0.23, 0.43) for self-reported physical function
Fransen et al[13](2003)	Systematic review	Land-based therapeutic exercise was shown to reduce pain and improve physical function for people with OA of the knee. SMD (95% CI) was 0.39 (0.30, 0.47) for pain and 0.31 (0.23, 0.39) for self-reported physical function
Roddy et al[14](2005)	Systematic review	Both aerobic walking and home-based quadriceps strengthening exercise reduced pain and disability from OA of the knee. Pooled effect sizes for pain were 0.52 for aerobic walking and 0.32 for quadriceps strengthening
Devos-Comby et al[15](2006)	Meta-analysis	Exercise regimens led to improvement in physical health (by self-report and direct measures) and in overall impact of OA of the knee. Exercise had a moderate, but clinically important influence on patients’ well-being
Vignon et al[16](2006)	Systematic review	Exercises and other structured activities had a favorable effect on pain and function in sedentary knee OA patients. Static exercises were not favored over dynamic exercises, availability, preference and tolerance being the criteria for the choice of exercise
Bartels et al[17](2007)	Cochrane review	Aquatic exercise had some beneficial short-term effects for patients with hip and/or knee OA: SMD (95% CI) was 0.26 (0.11, 0.42) for function and 0.32 (0.03, 0.61) for quality of life. A minor effect of a 3% absolute reduction and 6.6% relative reduction from baseline was found for pain
Pisters et al[18](2007)	Systematic review	Strong evidence was found for no long-term effectiveness of exercise 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 in patients with OA of the hip and/or knee
Fransen et al[19,20](2008, 2009)	Meta-analysis	Land-based therapeutic exercise had at least short-term benefit in terms of reduced knee pain and physical disability for people with OA of the knee: SMD (95% CI) was 0.40 (0.30, 0.50) for knee pain and 0.37 (0.25, 0.49) for physical function

OA: Osteoarthritis; SMD: Standardized mean difference.