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Evidence Summary (Added 2022)
A systematic review and meta-analyses of over 1500 knee OA patients in 20 RCTs and 2 case series, found significant improvements in the physical functions scores of WOMAC and the ADL score of KOOS. This was seen across 4 PA interventions (aquatic, land-based, Tai-Chi and Yoga) compared to control groups(4). Similarly a Cochrane review showed improved physical function outcomes across 13 studies (SMD -0.27, 95%CI -0.37 to -0.17).(3) Significant improvements in function have been found in the following physical activity interventions; yoga(5), aquatic, land-based and Tai-chi(4).
A review of 103 RCTs and over 9000 patients showed an improvement in function of all PA intervention compared to usual care with effect sizes from 0.4 to 1.1(6). Li et al. found improvements in function(p<0.001) when comparing traditional Chinese exercise interventions to comparators despite moderate heterogeneity (I2=34%).(7)
Other functional outcomes measures of performance such as the 6-minute walk test and timed up and go were used to assess function. The finding were inconsistent with Raposo et al, reporting on 3 of 15 studies showing improvements in the 6MWT (ES 0.15 to 0.38).(8)
Quality of evidence
B – Moderate quality
Strength of recommendation
1 – Strong
Conclusion
Physical activity interventions can improve function. While studies in the meta-analysis were mostly RCTs, the heterogeneity of studies included varied from low to high. (I2 range from 0% to 57%)(4) and quality of evidence in other studies was moderate(3)(9). Improvements in function in osteoarthritis can be seen across a number of physical activity interventions.
References
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