Therapeutic exercise for people with osteoarthritis of the hip or knee. A systematic review

To determine whether land based therapeutic exercise is beneficial for people with osteoarthritis (OA) of the hip or knee in terms of reduced joint pain, improved physical function, and/or the patient's global assessment of therapeutic effectiveness. Methods. Five databases were searched for randomized clinical trials. Standardized mean differences (SMD) with their 95% confidence intervals (CI) were calculated for each study and then combined using a fixed effects model. Results. Only 2 studies, totaling about 100 participants, could potentially provide data on people with hip OA. Fourteen studies provided data on 1633 participants with knee OA. Nine of these studies were considered of high methodological quality. For pain, combining the results revealed a mean moderate beneficial effect (SMD 0.46, 95% CI 0.35, 0.57), while for self-reported physical function a mean small beneficial effect (SMD 0.33, 95% Cl 0.23, 0.43) was found. These results appeared to be sensitive to blinding of outcome assessor and choice of control group. Conclusion. Land based therapeutic exercise was shown to reduce pain and improve physical function for people with OA of the knee.