Comparative efficacy and safety of exercise modalities in knee osteoarthritis: systematic review and network meta-analysis

作者：Lei Yan, Dijun Li, Dan Xing, Zijuan Fan, Guangyuan Du, Jingwei Jiu, Xiaoke Li, Janne Estill, Qi Wang, Ahmed Belal, Chen Tian, Jiao Jiao Li, Songyan Li, Haifeng Liu, Xuanbo Liu, Yijia Ren, Yiqi Yang, Jinxiu Chen, Yihe Hu, Long Ge, Bin Wang · 发表于：BMJ · 年份：2025 · DOI：10.1136/bmj-2025-085242 · 被引用次数：28 · 研究领域：Osteoarthritis Treatment and Mechanisms、Sports Performance and Training、Total Knee Arthroplasty Outcomes

OBJECTIVE: To assess the efficacy and safety of various exercise modalities as therapeutic interventions for managing knee osteoarthritis. DESIGN: Systematic review with network meta-analysis. DATA SOURCES: PubMed, Embase, Cochrane Library, Web of Science, CINAHL, PsycINFO, AMED, PEDro, Scopus, ClinicalTrials.gov, ICTRP, and ClinicalTrialsRegister.eu from database inception to August 2024. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials comparing different exercise modalities, including aerobic exercise, flexibility exercise, mind-body exercise, neuromotor exercise, strengthening exercise, mixed exercise, and control group for patients with knee osteoarthritis. MAIN OUTCOME MEASURES: Primary outcomes included pain, function, gait performance, and quality of life, assessed at short term (four weeks), mid-term (12 weeks), and long term (24 weeks) follow-up. When exact time points were unavailable, data from adjacent time windows were used. RESULTS: 217 randomised controlled trials involving 15 684 participants were included. Moderate certainty evidence showed that, compared with the control group, aerobic exercise probably results in large improvements in pain at short term (standardised mean difference -1.10, 95% confidence interval -1.68 to -0.52) and mid-term follow-up (-1.19, -1.59 to -0.79), function at mid-term (1.78, 1.05 to 2.51), gait performance at mid-term (0.85, 0.55 to 1.14), and quality of life at short term (1.53, 0.47 to 2.59). Mind-body...