Effect of high-intensity training on improving knee flexion strength and quality of life in patients with knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials
Bibliographic record
Abstract
Objectives: Whether high-intensity exercise can effectively improve the symptoms and quality of life of patients with knee osteoarthritis has not been determined. This study updates the evidence on the efficacy of high-intensity training for patients with knee osteoarthritis by integrating all large-scale randomized controlled trials (RCTs). Methods: A systematic literature search was conducted in PubMed, Embase, Web of Science, and Cochrane through November 2024. Outcomes assessed included Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), 6-min walk test (6-MWT), knee flexion strength, knee extension strength, leg press strength, Knee Injury and Osteoarthritis Outcome Score (KOOS) (pain, symptoms, and QoL), stair climbing test, and timed-up-and-go (TUG). Standardized mean differences (SMD) with 95% confidence intervals (CI) were used to pool continuous variables. Sensitivity analysis was performed to assess result stability. Analyses were conducted using Review Manager 5.4 and STATA 15.1. Results: Nine RCTs with 1,540 patients were included. The average age of the patients ranged from 59.1 to 69 years. Meta-analysis showed significant improvements in knee flexion strength (SMD: 0.39; 95% CI: 0.08, 0.70), leg press strength (SMD: 0.47; 95% CI: 0.23, 0.70), KOOS symptoms (SMD: 0.18; 95% CI: 0.02, 0.35), and KOOS QoL (SMD: 0.29; 95% CI: 0.13, 0.45) in the high-intensity exercise group compared to the control. However, high-intensity exercise had no significant effect on WOMAC, 6-MWT, knee extension strength, KOOS pain, stair climbing, or TUG. Conclusion: High-intensity exercise significantly improves knee flexion strength, leg press strength, and KOOS symptoms and QoL in knee osteoarthritis patients. Given the study's limitations, further large-scale, multicenter RCTs are needed to confirm the rehabilitation effects and potential influencing factors of high-intensity exercise. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.016 | 0.035 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.024 | 0.034 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".