Effectiveness of exercise therapy in patients with knee osteoarthritis: an overview of systematic reviews
Bibliographic record
Abstract
OBJECTIVE: This study aimed to assess the methodological quality of published systematic reviews of exercise therapy in knee osteoarthritis and summarise their reported effectiveness on quality of life, knee joint function, or adverse events. DESIGN: Overview of systematic reviews. DATA SOURCES: PubMed, Embase, CINAHL, Web of Science and CENTRAL (searched on 14 April 2025), plus grey literature (PROSPERO, Epistemonikos, OpenGrey). ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We included systematic reviews of randomised controlled trials in patients diagnosed with knee osteoarthritis by imaging or clinical criteria and treated conservatively with exercise therapy; we excluded reviews that enrolled patients scheduled for surgery, with acute inflammation or osteoarthritis of other joints (hand, hip, ankle), for which relevant author data could not be obtained after one contact attempt, or that did not report at least one primary outcome (quality of life, knee joint function or adverse events). DATA EXTRACTION AND SYNTHESIS: Two reviewers independently extracted data on study characteristics, interventions and outcomes, and assessed methodological quality using the AMSTAR 2 (A MeaSurement Tool to Assess systematic Reviews 2) tool. Due to heterogeneity in outcome measures across systematic reviews, meta-analysis was not conducted. Effectiveness was defined as any reported beneficial outcome of exercise therapy on predefined outcomes, including quality of life, physical function, pain or adverse events. RESULTS: 58 systematic reviews were selected. Muscle-strengthening (74.1%) and aerobic (48.2%) exercises were the most commonly prescribed exercise-based interventions. SF-36 (36-Item Short Form Health Survey) and the WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) were the most popular outcome-evaluation tools. Furthermore, 63.7% of the systematic reviews revealed that exercise therapy improved all outcomes. The number of intervention-related adverse events was small. Notably, almost all systematic reviews (87.4%) had a critically low quality. CONCLUSIONS: Current evidence on exercise therapy for knee osteoarthritis is inadequate. Nevertheless, exercise therapy can be considered for conservative treatment of knee osteoarthritis. Future studies should use network meta-analyses to compare the effects of different exercise therapies and determine their superiority over other conservative therapies.
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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 | 0.046 | 0.136 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.017 | 0.018 |
| Bibliometrics | 0.019 | 0.014 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 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".