Review Is exercise eVective treatment for osteoarthritis of the knee?

Objective—To review and determine the eVectiveness of exercise treatment in osteoarthritis of the knee. Methods—A computerised literature search of Medline was carried out searching between June 1966 and January 2000. Results—Twenty three randomised controlled trials were identified from the literature. Only three trials were suYciently powered. Small to moderate beneficial eVects of exercise treatment were found for pain, small beneficial eVects on disability outcome measures, and moderate to great beneficial eVects were observed according to patient global assessment of eVect. It was not possible to obtain evidence on the content of exercise interventions, as studies were hampered by lack of attention to proper concealment, reporting of adverse eVects, and long term eVects of exercise treatment. The lack of standard outcomes measures is also noted. Conclusions—The available evidence indicates beneficial short term eVects of exercise treatment in patients with osteoarthritis of the knee. However, the number of available studies is limited, and more research is needed to expand this recommendation. Specifically, additional trials should provide information on adherence, home based interventions, interaction with pharmacological treatments, functional outcomes measures relevant to exercise treatment in these patients, and long term eVects. At present, doctors should recommend exercise to all patients with mild/moderate disease. Further study should be encouraged and exercise should be continued to be recommended as a mainstay of non-pharmacological treatment of osteoarthritis of the knee. (Br J Sports Med 2000;34:326–331)