Evidence map›Paper›PMID 41706544›Full record

Trial reportArthritis care & research2026

Moderators of the Effects of Exercise and Manual Therapy for People With Knee and Hip Osteoarthritis: A Secondary Analysis of a Randomized Clinical Trial.

Daniel Cury Ribeiro, Sarah E Lamb, J Haxby Abbott

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Arthritis care & research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

3 authors.

Daniel Cury RibeiroCurtin University, Perth, Western Australia, Australia.ORCID https://orcid.org/0000-0001-9287-9187
Sarah E LambUniversity of Exeter, St Luke's Campus, Exeter, United Kingdom.
J Haxby AbbottUniversity of Otago, Dunedin, New Zealand.ORCID https://orcid.org/0000-0001-6468-7284

Funding

Health Research Council of New Zealand 07/200Health Research Council of New Zealand 18/111
6 · The paper itself

Abstract

objectiveThis study aimed to investigate potential moderators influencing the effects of manual therapy and exercise therapy on pain and functional outcomes in individuals with knee and/or hip osteoarthritis, using data from the MOA trial. This is a secondary analysis of data from the MOA trial that compares the clinical effectiveness of manual therapy and/or exercise therapy in addition to usual care for patients with hip and/or knee osteoarthritis.

methodsA total of 206 participants were analyzed. The primary outcome measure was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) composite score after one year. The secondary outcome measures were WOMAC pain and function scores. We used linear regression models for assessing whether the effect of randomized interventions on pain and function was moderated by body mass index (BMI), pain self-efficacy, quadriceps strength, mental health, and education.

resultsBMI moderated the treatment effects of manual therapy interventions on WOMAC composite (β -4.1, 95% confidence interval [CI] -6.6 to -1.7), function (β -3.3, 95% CI -5.1 to -1.6), and pain scores (β -0.6, 95% CI -1.3 to 0.0) when compared to usual care. A negative β reflects an improvement in outcome associated with each one-unit increase in BMI. Mental health moderated (β 16.8, 95% CI 2.2-31.4) treatment effects of manual therapy interventions when compared to usual care. No other moderation effect was identified.

conclusionOur findings suggest manual therapy may prove to be a more suitable treatment for people with higher BMI and should undergo further trials. Future trials should continue to explore which variables moderate treatment effects when testing effectiveness of nonsurgical interventions in patients with hip or knee osteoarthritis.

Indexed as

Exercise TherapyMusculoskeletal ManipulationsOsteoarthritis, HipOsteoarthritis, KneeAgedBody Mass IndexFemaleHumansMaleMiddle AgedPain MeasurementSecondary Data AnalysisTreatment Effect HeterogeneityTreatment Outcome

Identifiers

PMID41706544
PMCPMC13511360

What Socratic holds

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Registered trials

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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.