Evidence map›Paper›PMID 42539643›Full record

SynthesisFrontiers in medicine2026

Comparative efficacy of early exercise interventions for recovery outcomes after total knee arthroplasty: a systematic review and network meta-analysis.

Xinyue Yan, PinMei Li, Jia Li, Liting Song, Jiapeng Jing, Xiaochen Fu, Zhuo Xu

Abstract readSystematic Review
In one paragraph

Synthesis in Frontiers in medicine, 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
–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

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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

7 authors.

Xinyue YanDepartment of Rehabilitation, China-Japan Union Hospital of Jilin University, Changchun, China.
PinMei LiDepartment of Rehabilitation, China-Japan Union Hospital of Jilin University, Changchun, China.
Jia LiDepartment of Rehabilitation, China-Japan Union Hospital of Jilin University, Changchun, China.
Liting SongDepartment of Rehabilitation, China-Japan Union Hospital of Jilin University, Changchun, China.
Jiapeng JingDepartment of Rehabilitation, The Second Hospital of Jilin University, Changchun, China.
Xiaochen FuDepartment of Rehabilitation, China-Japan Union Hospital of Jilin University, Changchun, China.
Zhuo XuDepartment of Rehabilitation, China-Japan Union Hospital of Jilin University, Changchun, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Early rehabilitation after total knee arthroplasty (TKA) is essential for pain relief and functional recovery. Although exercise is a core component of rehabilitation, the comparative effectiveness and optimal protocols of specific exercise modalities within the 3-day postoperative "golden period" remain uncertain. This network meta-analysis (NMA) compared the effects of different early exercise interventions (initiated ≤3 days post-TKA) on pain, joint function (WOMAC), and range of motion (ROM) and ranked their efficacy. Methods: Randomized controlled trials (RCTs) were systematically searched for using the PubMed, Embase, Cochrane Library, Web of Science, and Scopus databases for studies published in the past 10 years. Two reviewers independently screened the studies, extracted the data, and assessed the risk of bias using Cochrane Risk of Bias Tool (RoB2). A frequentist random-effects NMA was performed using Stata 18.0. Interventions were ranked using the surface under the cumulative ranking curve (SUCRA) values, and evidence certainty was evaluated using CINeMA. Results: A total of 32 RCTs (1,871 patients) evaluating nine interventions were included. In terms of pain relief, functional training and resistance training showed favorable comparative effects versus the control, with relatively high ranking probabilities (SMD: -4.23 and -1.57; SUCRA: 100 and 85.8%, respectively). For WOMAC-based functional status, functional training and intelligence-assisted training appeared to provide greater improvement than the other interventions in the current network (SMD: -1.51 and -1.35; SUCRA: 85.5 and 78.7%, respectively). Regarding ROM improvement, intelligence-assisted training and resistance training had the highest ranking probabilities and showed favorable effect estimates (SMD: 2.21 and 1.91; SUCRA: 94.7 and 88.9%, respectively). According to CINeMA, the certainty of evidence was moderate for pain and low for WOMAC and ROM. Conclusion: Functional training, intelligence-assisted training, and resistance training appeared to be promising early exercise strategies after TKA. Functional training showed favorable comparative effects on pain relief and functional improvement, while intelligence-assisted training demonstrated potential benefits across all three outcomes. To optimize patient recovery, clinicians should tailor the selection and combination of these interventions on the basis of the rehabilitation stage and goals. Systematic review registration: PROSPERO (CRD420251041523).

Indexed as

early rehabilitationexercise therapyjoint functionpainrange of motiontotal knee arthroplasty

Identifiers

PMID42539643
PMCPMC13424120

What Socratic holds

Textmetadata
LicenceCC BY
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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.