New Delhi: Effects of exercise on easing symptoms of osteoarthritis are likely minimal, short lived, and probably no better than no treatment at all, suggests an analysis of previously published evidence and reviews.
The findings, published in the journal Rheumatic and Musculoskeletal Diseases (RMD) Open, challenge the promotion of exercise as a first line of treatment to ease pain and improve physical function among the affected, and highlight the need to revisit research priorities, researchers said.
The team, including authors from Bochum University of Applied Sciences in Germany, said an emerging body of evidence has questioned the extent and durability of effects of exercise, which is consistently recommended as an initial treatment for osteoarthritis.
The researchers said there has been no comprehensive review of published evidence comparing exercise with a range of varied approaches, including placebo, usual care and doing nothing, even as numerous systematic reviews have been published.
Data from five systematic reviews and 28 randomised clinical trials were analysed, involving over 12,000 participants.
“Evidence on exercise for osteoarthritis remains largely inconclusive, suggesting negligible or short-lasting small effects comparable to, or less effective than, other treatments,” the authors wrote.
They said evidence indicated small, short-term effects of exercise versus placebo and no-treatment for knee osteoarthritis pain, but certainty of evidence was very low and effects in larger or longer-term trials were smaller.
Evidence with a moderate certainty suggested negligible effects for hip, and small effects for hand, osteoarthritis, the researchers said.
They added that evidence of varying certainty suggested outcomes comparable to patient education, manual therapy, use of painkillers, steroid or hyaluronic acid injections, and keyhole knee surgery (arthroscopy).
Further, single trials in particular groups of patients showed that exercise was less effective than knee bone remodelling surgery (osteotomy) and joint replacement over the longer term.
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