The control group matters: Pain, physical function and strength improvements relative to the comparator intervention in knee and hip osteoarthritis
Authors' conclusion
In knee and hip OA, the effects of resistance exercise on pain and function improvements depend on the comparator intervention. For knee OA, a dose-response relationship was observed between lower extremity strength gains with pain and function improvements.
Study context
- Population
- Randomized controlled trials (RCTs) in knee and hip osteoarthritis (OA) (6 databases, inception to January 28 2023)257 knee OA, 15 hip OA studies
- Comparison
- Land-based resistance exercise-only interventions vs NONE, EXE, NONEXE or COMBO comparators
- Outcome
- Between-group effect (ES) on pain and function (ADL and SPORT)
- Follow-up
- Immediate post-intervention
Methodological detailsmeta-regression, subgroups by comparator intervention
- Meta-regression
- Subgroups by comparator intervention
Pooled result
As reported in the abstract
Knee OA pain, ES
ES
−0.92
95 % CI −1.15 to −0.69
Resistance exercise vs NONE · large benefit favouring resistance exercise
ES
0.44
95 % CI 0.23–0.65
COMBO vs Resistance exercise · moderate benefit favouring COMBO
Further pooled results
| Outcome | Estimate |
|---|---|
| Knee OA function (ADL and SPORT), ES · immediate post-interventionResistance exercise vs NONE · large benefit favouring resistance exercise | ES (ADL) −0.79 (CI −1.01 to −0.56) |
| Knee OA function (ADL and SPORT), ES · immediate post-interventionResistance exercise vs NONE · large benefit favouring resistance exercise | ES (SPORT) −0.79 (CI −1.02 to −0.56) |
| Hip OA pain, ES · immediate post-interventionResistance exercise vs NONE · moderate benefit favouring exercise interventions | ES −0.51 (CI −0.68 to −0.33) |
| Hip OA pain, ES · immediate post-interventionNONEXE vs Resistance exercise · moderate benefit favouring NONEXE | ES 0.57 (CI 0.17–0.97) |
| Hip OA function (ADL and SPORT), ES · immediate post-interventionResistance exercise vs NONE · moderate benefit favouring exercise interventions | ES (ADL) −0.57 (CI −0.78 to −0.36) |
| Hip OA function (ADL and SPORT), ES · immediate post-interventionResistance exercise vs NONE · moderate benefit favouring exercise interventions | ES (SPORT) −0.52 (CI −0.70 to −0.35) |
- Hip OA pain, ES: 15 studies
Knee OA: strength gains vs improvement in pain, activities of daily living (ADL), sports/recreation (SPORT) (meta-regression)
- β pain
- −0.24 (95 % CI −0.38, −0.09)
- β ADL (−0.73, −0.12)
- −0.43
- β SPORT (−0.73, −0.00)
- −0.37
- Greater strength gains associated with larger improvements
Original publication
The control group matters: Pain, physical function and strength improvements relative to the comparator intervention in knee and hip osteoarthritis. Semin Arthritis Rheum. Published 16 August 2024. doi:10.
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