Evidence map›Paper›PMID 31121333›Full record

SynthesisAnnals of physical and rehabilitation medicine2019

Efficacy and potential determinants of exercise therapy in knee and hip osteoarthritis: A systematic review and meta-analysis.

Siew-Li Goh, Monica S M Persson, Joanne Stocks, Yunfei Hou, Jianhao Lin, Michelle C Hall, Michael Doherty, Weiya Zhang

Registry-linked trialOpen access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Annals of physical and rehabilitation medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07613749 (EFFECT OF MECHANICAL TRACTION APPLIED BEFORE VERSUS AFTER THERAPEUTIC EXERCISES ON CLINICAL AND FUNCTIONAL OUTCOMES IN PRIMARY KNEE OSTEOARTHRITIS), which is not on this map. Cited by 102 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
102citing papers in PubMed, 11 pooled it
19.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07613749 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Effect of mechanical traction applied before versus after therapeutic exercises on clinical and functional outcomes in primary knee osteoarthritis

TypeinterventionalSponsorCairo UniversityRan2026 to 2027Enrolled63ConditionsKnee Osteoarthritis, Mechanical TractionArmsGroup A: Therapeutic exercise group, Group B: mechanical traction followed by therapeutic exercise, Group C: therapeutic exercise followed by mechanical traction
3 · Its place in the literature

Who cites it

102 citing papers in PubMed, 11 syntheses or guidelines pooled it, 454 citations in OpenAlex.

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  5. Exercise for osteoarthritis of the knee.The Cochrane database of systematic reviews · 2024
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42 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 3 countries.

Siew-Li GohArthritis Research UK Pain Centre, Academic Rheumatology, University of Nottingham, Clinical Sciences Building, City Hospital, NG5 1PB Nottingham, UK; Sports Medicine Unit, University of Malaya, 50603 Kuala Lumpur, Malaysia.
Monica S M PerssonArthritis Research UK Pain Centre, Academic Rheumatology, University of Nottingham, Clinical Sciences Building, City Hospital, NG5 1PB Nottingham, UK.
Joanne StocksArthritis Research UK Pain Centre, Academic Rheumatology, University of Nottingham, Clinical Sciences Building, City Hospital, NG5 1PB Nottingham, UK.
Yunfei HouArthritis Clinical and Research Centre, Peking University People's Hospital, Beijing, China.
Jianhao LinArthritis Clinical and Research Centre, Peking University People's Hospital, Beijing, China.
Michelle C HallDivision of Physiotherapy Rehabilitation Sciences Education, University of Nottingham, NG5 1PB Nottingham, UK.
Michael DohertyArthritis Research UK Pain Centre, Academic Rheumatology, University of Nottingham, Clinical Sciences Building, City Hospital, NG5 1PB Nottingham, UK.
Weiya ZhangArthritis Research UK Pain Centre, Academic Rheumatology, University of Nottingham, Clinical Sciences Building, City Hospital, NG5 1PB Nottingham, UK. Electronic address: weiya.zhang@nottingham.ac.uk.
University of Nottingham · GBPeking University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundExercise is an effective treatment for osteoarthritis. However, the effect may vary from one patient (or study) to another.

objectiveTo evaluate the efficacy of exercise and its potential determinants for pain, function, performance, and quality of life (QoL) in knee and hip osteoarthritis (OA).

methodsWe searched 9 electronic databases (AMED, CENTRAL, CINAHL, EMBASE, MEDLINE Ovid, PEDro, PubMed, SPORTDiscus and Google Scholar) for reports of randomised controlled trials (RCTs) comparing exercise-only interventions with usual care. The search was performed from inception up to December 2017 with no language restriction. The effect size (ES), with its 95% confidence interval (CI), was calculated on the basis of between-group standardised mean differences. The primary endpoint was at or nearest to 8 weeks. Other outcome time points were grouped into intervals, from<1 month to≥18 months, for time-dependent effects analysis. Potential determinants were explored by subgroup analyses. Level of significance was set at P≤0.10.

resultsData from 77 RCTs (6472 participants) confirmed statistically significant exercise benefits for pain (ES 0.56, 95% CI 0.44-0.68), function (0.50, 0.38-0.63), performance (0.46, 0.35-0.57), and QoL (0.21, 0.11-0.31) at or nearest to 8 weeks. Across all outcomes, the effects appeared to peak around 2 months and then gradually decreased and became no better than usual care after 9 months. Better pain relief was reported by trials investigating participants who were younger (mean age<60 years), had knee OA, and were not awaiting joint replacement surgery.

conclusionsExercise significantly reduces pain and improves function, performance and QoL in people with knee and hip OA as compared with usual care at 8 weeks. The effects are maximal around 2 months and thereafter slowly diminish, being no better than usual care at 9 to 18 months. Participants with younger age, knee OA and not awaiting joint replacement may benefit more from exercise therapy. These potential determinants, identified by study-level analyses, may have implied ecological bias and need to be confirmed with individual patient data.

Indexed as

AdultAgedExercise TherapyFemaleHumansMaleMiddle AgedOsteoarthritis, HipOsteoarthritis, KneePain MeasurementQuality of LifeRandomized Controlled Trials as TopicTreatment OutcomeDeterminantsExerciseFunctionKnee osteoarthritisMeta-analysisPainPhysical therapyQuality of Life

Identifiers

PMID31121333
PMCPMC6880792
OpenAlexW2945870087

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.