SynthesisFrontiers in medicine2024
Efficacy of lower limb strengthening exercises based on different muscle contraction characteristics for knee osteoarthritis: a systematic review and network meta-analysis.
Synthesis in Frontiers in medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
What it found
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A meta-analysis of randomized controlled trials: evaluating the efficacy of isokinetic muscle strengthening training in improving knee osteoarthritis outcomes.Journal of orthopaedic surgery and research · 2025Pooled it
- Effects of Strengthening-Based Home Exercise Program on Pain and Function in Knee Osteoarthritis: Phase I Results of a Two-Phase Randomized Controlled Trial.Health science reports · 2026Article
- Neuromuscular exercise combined with pain neuroscience education for knee osteoarthritis management in older women: protocol for a randomized controlled trial.Journal of orthopaedic surgery and research · 2026Article
- Vacuum-Compression Therapy as an Adjunct to Physical Therapy in Patients with Knee Osteoarthritis: A Pilot Comparative Study.Bioengineering (Basel, Switzerland) · 2026Article
- Neuromuscular and Kinematic Strategies During Step-Up and Down-Forwards Task in Individuals with Knee Osteoarthritis.Journal of clinical medicine · 2026Article
- Validity of DEXA-Derived Thigh Muscle Quantification Against AI-Assisted CT: Inter-Limb Asymmetry Provides Superior Agreement over Absolute Values.Journal of clinical medicine · 2026Article
- Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: While strengthening exercises are recommended for knee osteoarthritis (KOA) treatment, the optimal type of muscle contraction remains unclear, with current research showing conflicting results. This network meta-analysis (NMA) aims to evaluate the efficacy of lower limb strengthening exercises based on different muscle contraction characteristics for KOA patients and provide clinical references. Methods: We conducted the NMA following the PRISMA-NMA. A comprehensive search of five databases (PubMed, Web of Science, CENTRAL, Embase, and SPORTDiscus) up to August 2024 identified randomized controlled trials (RCTs) investigating lower limb strengthening exercises in KOA patients. Control groups included receiving usual care, only providing health education, or no intervention at all. Outcomes analyzed included pain, physical function, quality of life, and muscle strength. Results: Forty-one studies (2,251 participants) were included. Twenty-eight studies used rigorous randomization; eighteen reported allocation concealment. All had high performance bias risk due to exercise interventions. Regarding efficacy, isokinetic exercise ranked highest in pain relief (SMD = 0.70, 95% CI: 0.50-0.91, SUCRA = 82.6%), function improvement (SMD = 0.75, 95% CI: 0.57-0.92, SUCRA = 96.1%), and enhancement in muscle strength (SMD = 0.56, 95% CI: 0.34-0.78, SUCRA = 90.1%). Isometric exercise ranked highest in improving quality of life (SMD = 0.80, 95% CI: 0.28-1.31, SUCRA = 90.5%). Mixed strengthening exercise ranked lowest across all outcomes. High-frequency interventions (≥5 times/week) showed superior pain relief compared with low-frequency (≤3 times/week) for isotonic, isometric, and isokinetic exercise. Conclusion: This NMA suggests isokinetic exercise may be most effective for pain, function, and muscle strength in KOA patients, while isometric exercise benefits quality of life most. Mixed strengthening exercise ranked lowest across all outcomes. High-frequency interventions appear more effective than low-frequency ones. These findings support personalized KOA treatment, considering efficacy, accessibility, and patient-specific factors. Study biases, heterogeneity, and other limitations may affect result reliability. Future research should focus on high-quality studies with standardized protocols and analyze dose-response relationships to refine KOA treatment strategies. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024582525, identifier: CRD42024582525.
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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.