OP0227-HPR Does Exercise Therapy Improve Health-Related Quality of Life in People with Knee Osteoarthritis? A Systematic Review
Authors: R. Tanaka, J. Ozawa, N. Kito, H. Moriyama
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> There is convincing evidence for the overall effectiveness of exercise in people with knee osteoarthritis (OA) [1]. However, according to the EULAR recommendations [2], most trials found in the literature review used pain or physical function as the primary outcome and surprisingly few included quality of life outcome measures. Measurement of health-related quality of life (HRQOL) and utility is recommended [3]. <h3>Objectives</h3> The aim of this systematic review and meta-analysis was to examine the effects of exercise therapy on the HRQOL of people with knee OA. <h3>Methods</h3> <i>Data Sources:</i> The electronic databases PubMed, CENTRAL, PEDro, and CINAHL were searched from the earliest date possible through January 2014. <i>Study Selection and eligibility criteria:</i> Randomized controlled trials that evaluated the effects of exercise therapy on HRQOL as assessed with the SF-36 were included for review. Only studies with a control group that received either no intervention or a psychoeducational intervention were included. <h3>Data Extraction and Data Synthesis</h3> The data were extracted using a predefined data extraction form by a single reviewer and checked for accuracy by another reviewer. The methodological qualities of the trials were assessed independently by two reviewers using the PEDro scale. Pooled analyses with a random-effects model or a fixed-effects model were used in the meta-analyses to calculate the standardized mean differences and 95% confidence intervals. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was applied to each meta-analysis performed to determine the quality of the evidence. <h3>Results</h3> Twelve studies met the inclusion criteria. Our meta-analysis provided high-quality evidence that exercise therapy increased the summary (SMD =0.47, 95% CI: 0.16 to 0.78, <i>I</i><sup>2</sup> =0%), physical functioning (SMD =0.28, 95% CI: 0.12 to 0.45, <i>I</i><sup>2</sup> =0%), and role-physical domain scores (SMD =0.26, 95% CI: 0.10 to 0.43, <i>I</i><sup>2</sup> =19%) of knee OA people. Our meta-analysis also provided moderate-quality evidence that the physical component summary (SMD =0.52, 95% CI: 0.21 to 0.83, <i>I</i><sup>2</sup> =76%) and mental component summary scores (SMD =0.44, 95% CI: 0.12 to 0.75, <i>I</i><sup>2</sup> =77%) improved to a greater extent by exercise therapy than by control interventions. <h3>Conclusions</h3> Exercise therapy can improve HRQOL as assessed with the SF-36 in people with knee OA. <h3>References</h3> Tanaka R, Ozawa J, Kito N, Yamasaki T, Moriyama H. Evidence of improvement in various impairments by exercise interventions in patients with knee osteoarthritis: a systematic review and meta-analysis of randomized clinical trials. Journal of Japanese Physical Therapy Association. 2013; 16(1):7-21. Fernandes L, Hagen KB, Bijlsma JW, Andreassen O, Christensen P, Conaghan PG, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann Rheum Dis. 2013 Jul; 72(7):1125-1135. Maheu E, Altman RD, Bloch DA, Doherty M, Hochberg M, Mannoni A, et al. Design and conduct of clinical trials in patients with osteoarthritis of the hand: recommendations from a task force of the Osteoarthritis Research Society International. Osteoarthritis Cartilage. 2006 Apr; 14(4):303-322. <h3>Disclosure of Interest</h3> None declared