New Delhi, February 18 The effects of exercise on alleviating the symptoms of osteoarthritis are likely to be minimal, short-lived, and probably no better than no treatment at all, according to 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 treatment to ease pain and improve physical function among those affected, and highlight the need to revisit research priorities, researchers said.
The team, including authors from Bochum University of Applied Sciences in Germany, said that an emerging body of evidence has questioned the extent and durability of the effects of exercise, which is consistently recommended as an initial treatment for osteoarthritis.
The researchers said that 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 randomized clinical trials were analyzed, 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 that evidence indicated small, short-term effects of exercise versus placebo and no-treatment for knee osteoarthritis pain, but the certainty of the evidence was very low, and the effects in larger or longer-term trials were smaller.
Evidence with moderate certainty suggested negligible effects for hip osteoarthritis, and small effects for hand osteoarthritis, the researchers said.
They added that evidence of varying certainty suggested outcomes comparable to patient education, manual therapy, the 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.