Does a Home-based Exercise Program Play Any Role in the Treatment of Knee Osteoarthritis? A Meta-analysis

Background: Knee-osteoarthritis is a very common joint disorder, affecting about 85% of the population worldwide. The effectiveness of home-based exercises is still debatable, with many studies indicating positive outcomes with few side effects, while others find them of limited utility.

Objectives: To assess the role of home-based exercise (HBE) programs in the treatment of knee osteoarthritis.

Material And Methods: Randomized controlled trials were included as per the predefined Population, Intervention, Comparison, Outcomes and Study (PICOS) criteria. Demographic summaries and event data for osteoarthritis therapy in the exercise and control groups were assessed, and comparative efficacy was evaluated using clustered graphs. The RevMan software was used to calculate the odds ratio (OR) and risk ratio of the included studies. The risk of bias was also evaluated and heterogeneity analysis was performed.

Results: Fifteen clinical trials performed from 2000 to 2022, with a total of 2922 osteoarthritis patients, were included in the study, according to the chosen inclusion criteria. We observed a reduction in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores but a more marked improvement in clinical symptoms in the exercise group. The Knee Injury and Osteoarthritis Outcome Score (KOOS) increased only in the exercise group and not in the control group. We obtained a pooled OR of 0.59 (95% confidence interval (95% CI): 0.36-0.98), T2 value of 0.88, χ2 value of 185.41, degrees of freedom (df) value of 14, I2 value of 92%, and p-value <0.00001. The overall Z effect was 2.04 with a p-value of 0.04. The pooled risk ratio was 0.81 (95% CI: 0.66-0.99) with a T2 value of 0.14, χ2 value of 191.53, df value of 14, I2 value of 93%, and p-value <0.00001.

Conclusion: The data from the studies included in this meta-analysis are in favor of the use of HBEs for the treatment of knee osteoarthritis.