Effectiveness of exercise on pain intensity and physical function in patients with knee and hip osteoarthritis: an umbrella and mapping review with meta-meta-analysis

Abstract

Purpose: The aim of this review was to provide a qualitative and quantitative overview of the effects of exercise on pain, physical function, and quality of life for patients with knee and hip osteoarthritis. Materials and methods: This study was an umbrella and mapping review with meta-meta-analysis. Meta-analyses of randomized controlled trials were included. The methodological quality and risk of bias were evaluated using the Modified Quality Assessment Scale for Systematic Reviews and the Risk of Bias in Systematic Reviews tool. The quality of evidence was evaluated using the Physical Activity Guidelines Advisory Committee Grading Criteria. Results: 41 meta-analyses were included, 43.9% of the studies had adequate methodological quality, and 56.1% of the studies had a low risk of bias. Moderate evidence was found that exercise decreases pain intensity (33 meta-analyses; SMD=−0.49; 95% CI −0.56 to −0.42), improves function (19 meta-analyses; SMD=−0.50; 95% CI −0.58 to −0.41), strength (6 meta-analyses; SMD=−0.57; 95% CI −0.70 to −0.44) and quality of life (SMD=−0.36; 95% CI −0.46 to −0.27) for patients with hip and knee osteoarthritis. Conclusion: Exercise is an effective intervention to decrease pain intensity and improve function in patients with hip and knee osteoarthritis.