To evaluate the effectiveness of exercise as a treatment for osteoarthritis compared to other interventions, specifically focusing on pain and function outcomes.
Key Findings:
Exercise showed small, short-term effects on osteoarthritis pain compared to placebo (mean difference = −10.8) and no treatment (mean difference = −12.4).
Moderate-certainty evidence indicated negligible effects for hip osteoarthritis (mean difference = −6.7) and small effects for hand osteoarthritis (mean difference = −10).
Exercise outcomes were comparable to education, manual therapy, analgesics, injections, and arthroscopy.
Exercise was less effective in the long term compared to knee osteotomy (mean difference = 12.4) and joint replacement (knee: mean difference = 17.1; hip: mean difference = 24.2).
Interpretation:
The findings raise questions about the universal promotion of exercise for osteoarthritis and suggest a need for more focused research and clinical discussions regarding its effectiveness.
Limitations:
Very low certainty of evidence for exercise effects raises concerns about reliability.
Limited data on long-term durability of exercise benefits.
Ongoing publication of small trials may distort effect estimates.
Conclusion:
Clinical practice should involve discussions about the relative worth of exercise compared to other treatments, considering patient preferences, potential harms, and physician expertise.
