Early Knee Osteoarthritis: Exercise Therapy’s Golden Window

TOPLINE:

People with knee osteoarthritis and symptoms for less than 1 year benefit more from exercise therapy than those with longer symptom duration, especially when long-term outcomes are considered.

METHODOLOGY:

• Researchers conducted an individual participant data meta-analysis using data from the OA Trial Bank, including 1769 participants (mean age, 65.1 years; 66% women) with knee osteoarthritis from 1src randomized controlled trials.
• The participants were categorized on the basis of their symptom duration: ≤ 1 year,> 1 and ≤ 2 years, and> 2 years.
• This study included an exercise therapy group comprising land- and water-based therapeutic exercise interventions and a control group comprising no exercise or sham treatment.
• The primary outcomes were self-reported pain and physical function, standardized to a src-1srcsrc scale, at short-term (closest to 3 months) and long-term (closest to 12 months) follow-ups.

TAKEAWAY:

• The overall pain and physical function associated with osteoarthritis improved in the exercise therapy group at both short- and long-term follow-ups compared with in the control group.
• Exercise therapy led to a greater improvement in short-term (mean difference [MD], −3.57; P=.src28) and long-term (MD, −8.33; P <.srcsrc1) pain among participants with a symptom duration ≤ 1 year vs> 1 year.
• Similarly, those with a symptom duration ≤ 2 years vs> 2 years who underwent exercise therapy showed greater benefits in terms of short-term (P=.srcsrc1) and long-term (P <.srcsrc1) pain.
• Exercise therapy improved long-term physical function in those with a symptom duration ≤ 1 year vs> 1 year (MD, −5.46; P=.srcsrc5) and ≤ 2 years vs> 2 years (MD, −4.56; P=.srcsrc1).

IN PRACTICE:

“Exercise should be encouraged as early as possible once symptoms emerge in the disease process to take advantage of its effects in potentially [slowing] disease progression within the suggested ‘window of opportunity,'” the authors wrote.

SOURCE:

The study was led by Marienke van Middelkoop, PhD, Erasmus MC Medical University, Rotterdam, the Netherlands. It was published online on July 18, 2src24, in Osteoarthritis and Cartilage.

LIMITATIONS:

The dataset of most studies included in the meta-analysis lacked information on the radiographic severity of osteoarthritis. The relatively short follow-up time hindered interpreting the impact of exercise on the long-term progression of osteoarthritis. The reliance on patient recall for recording symptom duration may have led to misclassification.

DISCLOSURES:

The Netherlands Organisation for Health Research and Development supported this study. Three authors received funding from the Dutch Arthritis Society for the program grant Center of Excellence “OA prevention and early treatment – OA Pearl.” One author declared receiving royalties for the UpToDate knee osteoarthritis clinical guidelines.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.