Archives of Physical Medicine and Rehabilitation
VOLUME 105, ISSUE 5, P953-962, MAY 2024
Guan-Cheng Zhu, PhD
Published: July 16, 2023 DOI:https://doi.org/10.1016/j.apmr.2023.07.001
Highlights
• Stretching exercise can mitigate knee osteoarthritis-associated pain.
• Proprioceptive neuromuscular facilitation stretching programs are the most effective stretching exercises for pain relief in older adults with knee osteoarthritis.
• Mind-body exercises are the most effective in alleviating stiffness, while multi-component exercise programs are the most effective in reducing physical function disability in older adults with knee osteoarthritis.
Abstract
Objective
To assess and compare the effects of different stretching exercise programs on pain, stiffness, and physical function disability in older adults with knee osteoarthritis (KOA).
Data Sources
This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline for network meta-analysis (NMA). Relevant randomized controlled trials were identified by searching 7 databases up to December 2022.
Study Selection
Inclusion criteria included (1) older adults with KOA; (2) intervention included stretching exercises; (3) control groups received no stretching exercise; and (4) outcome measurements included pain, stiffness, or physical function disability. Methodological quality was assessed using the Cochrane risk-of-bias tool for randomized trials version 2.
Data Extraction
NMA was performed using R and MetaInsight, with results presented as a standardized mean difference (SMD) with 95% confidence interval (CI).
Data Synthesis
We examined 17 studies, and NMA results indicated that proprioceptive neuromuscular facilitation (PNF) stretching, mind-body exercises, and multi-component exercise programs were effective in mitigating pain in older adults with KOA (SMD=2.54 [95% CI: 1.23; 3.84], SMD=1.09 [95% CI: 0.27; 1.92], SMD=0.57 [95% CI: 0.06; 1.09]). Moreover, mind-body exercises and multi-component exercises were the most effective programs in reducing stiffness (SMD=1.31 [95% CI: 0.12; 2.51]) and physical function disability (SMD=1.67 [95% CI: 0.01; 3.33]) in older adults with KOA, respectively.
Conclusion
Findings suggest that PNF stretching, mind-body exercises, and multi-component exercises can be incorporated into exercise programs to better mitigate pain, stiffness, and physical function disability in older adults with KOA.