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Therapeutic Exercise for People with Osteoarthritis of the Hip or Knee. A Systematic Review
MARLENE FRANSEN, SARA McCONNELL, and MARY BELL
ABSTRACT.
Methods. Five databases were searched for randomized clinical trials. Standardized mean differences (SMD) with their 95% confidence intervals (CI) were calculated for each study and then combined using a fixed effects model. Results. Only 2 studies, totaling about 100 participants, could potentially provide data on people with hip OA. Fourteen studies provided data on 1633 participants with knee OA. Nine of these studies were considered of high methodological quality. For pain, combining the results revealed a mean moderate beneficial effect (SMD 0.46, 95% CI 0.35, 0.57), while for self-reported physical function a mean small beneficial effect (SMD 0.33, 95% CI 0.23, 0.43) was found. These results appeared to be sensitive to blinding of outcome assessor and choice of control group. Conclusion. Land based therapeutic exercise was shown to reduce pain and improve physical function for people with OA of the knee. (J Rheumatol 2002;29:1737-45) Key Indexing Terms:
OSTEOARTHRITIS
From the Institute for International Health, University of Sydney, Sydney, Australia; and the University of Toronto, Toronto, Ontario, Canada. Dr. Fransen was supported by the National Health and Medical Research Council of Australia. M. Fransen, PhD, Institute for International Health, University of Sydney; S. McConnell, MSc; M. Bell, MD, Department of Physical Therapy, University of Toronto. Address reprint requests to Dr. M. Fransen, Institute for International Health, University of Sydney, PO Box 576, Newtown, NSW 2042, Australia. E-mail: mfransen@iih.usyd.edu.au Submitted July 31, 2001; revision accepted January 30, 2002. |