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When it comes to knee osteoarthritis, the mantra “movement is medicine” has long been a cornerstone of treatment plans. However, a recent evidence review raises questions about just how effective exercise is at alleviating knee pain and improving overall quality of life.
The review, led by Belinda Lawford, a research fellow in physiotherapy at the University of Melbourne, suggests that while exercise provides measurable benefits, these improvements may not always meet the threshold for clinical significance.
Short-Term Gains, Limited Impact?
Published in the Cochrane Library, the study analyzed 139 clinical trials involving nearly 12,500 participants up until early January 2024. The findings revealed that exercise improved:
- Pain: By 8.7 to 13.1 points on a 100-point scale
- Physical function: By 9.7 to 12.5 points
- Quality of life: By 4.2 to 6.1 points
Although these numbers represent statistically significant improvements, they often fell short of what is considered a “minimal important difference” for patients. For exercise to make a noticeable impact, pain would need to improve by at least 12 points, physical function by 13 points, and quality of life by 15 points.
“The benefits were of uncertain clinical importance,” the authors wrote, noting that while exercise might provide some relief, it may not always translate into meaningful changes in a patient’s symptoms.
A Pillar of Treatment Under Scrutiny
The findings challenge the widely held belief that exercise is an essential component of osteoarthritis treatment. Organizations like the Arthritis Foundation have long recommended activities such as strength training, stretching, aerobics, and balance exercises to manage symptoms.
“Movement is an essential part of an osteoarthritis treatment plan,” the Arthritis Foundation states on its website.
However, the new review suggests that previous studies may have overestimated the benefits of exercise. The researchers pointed to the small sample sizes and inconsistent quality of many studies included in their analysis.
“Many studies are of poor quality with small sample sizes,” the report noted. “Therefore, some studies may have made the benefits of exercise seem greater than they are.”
What Does This Mean for Patients?
While the review does not dismiss the value of exercise, it underscores the need for tailored approaches to managing knee osteoarthritis. Patients should consult healthcare providers to develop a comprehensive treatment plan that includes, but is not solely reliant on, exercise.
The findings also highlight the importance of ongoing research to better understand how exercise interventions can be optimized for maximum benefit.
For more information, refer to the full study: Belinda J. Lawford et al., Exercise for Osteoarthritis of the Knee, Cochrane Database of Systematic Reviews (2024). DOI: 10.1002/14651858.CD004376.pub4.
Conclusion
Exercise remains a valuable tool in managing knee osteoarthritis, but its benefits may not be as transformative as once believed. By combining movement with other treatments, patients may find a more effective path to relief.
