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Exercise for lower limb osteoarthritis: systematic review incorporating trial sequential analysis and network meta-analysis
  1. Olalekan A Uthman1,2,
  2. Danielle A van der Windt1,
  3. Joanne L Jordan1,
  4. Krysia S Dziedzic1,
  5. Emma L Healey1,
  6. George M Peat1,
  7. Nadine E Foster1
  1. 1Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire ST5 5BG, UK
  2. 2Warwick Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL UK
  1. Correspondence to : D van der Windt; d.van.der.windt{at}keele.ac.uk

Abstract

STUDY QUESTION Which types of exercise intervention are most effective in relieving pain and improving function in people with lower limb osteoarthritis?

SUMMARY ANSWER As of 2002 sufficient evidence had accumulated to show significant benefit of exercise over no exercise. An approach combining exercises to increase strength, flexibility, and aerobic capacity is most likely to be effective for relieving pain and improving function.

WHAT IS KNOWN AND WHAT THIS PAPER ADDS Current international guidelines recommend therapeutic exercise (land or water based) as “core” and effective management of osteoarthritis. Evidence from this first network meta-analysis, largely based on studies in knee osteoarthritis, indicates that an intervention combining strengthening exercises with flexibility and aerobic exercise is most likely to improve outcomes of pain and function. Further trials of exercise versus no exercise are unlikely to overturn this positive result.

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