Evidence map›Paper›PMID 40890564›Full record

SynthesisPhysiotherapy research international : the journal for researchers and clinicians in physical therapy2025

The Efficacy of Closed Versus Open Kinetic Chain Exercise in Knee Osteoarthritis-A Systematic Review and Meta-Analysis.

Harrison J Michael, Harrison D Pham, Lok Sze Katrina Li, Adam I Semciw, Mark J Scholes, Madeline Hannington, Matthew G King

Abstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Physiotherapy research international : the journal for researchers and clinicians in physical therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. The Efficacy of Closed Versus Open Kinetic Chain Exercise in Knee Osteoarthritis-A Systematic Review and Meta-Analysis.Physiotherapy research international : the journal for researchers and clinicians in physical therapy · 2025
    Pooled it
  2. Article
  3. Exercise approaches in obese individuals with physical limitations.Turkish journal of physical medicine and rehabilitation · 2026
    Review
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

7 authors.

Harrison J MichaelDiscipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
Harrison D PhamDiscipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
Lok Sze Katrina LiDiscipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.ORCID https://orcid.org/0000-0001-5931-9567
Adam I SemciwDiscipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
Mark J ScholesDiscipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
Madeline HanningtonDiscipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.ORCID https://orcid.org/0000-0002-1305-1363
Matthew G KingDiscipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.ORCID https://orcid.org/0000-0003-0470-5924

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background/purposeDespite the prevalence of knee osteoarthritis, no consensus exists in the most effective exercise type for improving patient clinical outcomes. Therefore, we conducted a systematic review to compare the effectiveness of closed and open kinetic chain exercises (CKC and OKC) in reducing pain, increasing physical function and improving quality of life (QoL) in people with knee OA.

methodsWe searched PubMed, MEDLINE, EMBASE, CINAHL, PEDro, Scopus and Cochrane from inception to April 2024. Studies were included if they compared pain, physical function and QoL outcomes via a randomised controlled trial design in people with knee osteoarthritis. The Pedro Scale was used to assess the risk of bias, and the GRADE approach was used to determine the certainty of evidence. Outcomes were pooled in a random effects meta-analysis. 13 randomised controlled trials evaluating the efficacy of CKC versus OKC exercises in the short term (≤ 13 weeks) were included.

resultsLow-certainty evidence found that CKC exercises were superior to OKC exercises in the short term for improving pain (standardised mean difference (SMD) -0.18, 95% CI -0.37 to < 0.00; p = 0.048) and self-reported physical function (SMD -0.24, 95% CI -0.44 to -0.03, p = 0.022), with very low-certainty evidence of no difference in QoL outcomes (SMD -0.25, 95% CI -0.81 to 0.30, p = 0.370). DISCUSSION: To reduce pain and improve physical function in individuals with knee osteoarthritis in the short term, physiotherapists should prescribe CKC exercises. However, there is a paucity of information outlining the effects of these CKC versus OKC in the medium to long term. STUDY REGISTRATION NUMBER: PROSPERO (CRD42023470739).

Indexed as

Exercise TherapyOsteoarthritis, KneeHumansQuality of LifeRandomized Controlled Trials as TopicTreatment Outcomeclosed chain exerciseknee osteoarthritisopen chain exercisephysiotherapyrehabilitation

Identifiers

PMID40890564
PMCPMC12401799

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.