The Role of Physical Activity as Conservative Treatment for Hip and Knee Osteoarthritis in Older People: A Systematic Review and Meta-Analysis.

Biagio Zampogna,Vincenzo Denaro,Ferruccio Vorini,Guglielmo Torre,Giuseppe Francesco Papalia,Rocco Papalia,Chiara Fossati,Stefano Campi,Sebastiano Vasta

doi:10.3390/jcm9041167

Biagio Zampogna, Vincenzo Denaro + Show 7 more

Open Access

https://doi.org/10.3390/jcm9041167

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Abstract

The aim of this systematic review and meta-analysis is to determine the role of physical activity as a conservative treatment for older people with knee or hip osteoarthritis. The effect on pain, physical function, stiffness, quality of life, and dynamic balance of Aquatic Exercise, Land-based Exercise, and Sports were compared in a specific population composed of osteoarthritic patients aged 65 or over. A systematic search using Pubmed-Medline, Google Scholar, and the Cochrane Library was carried out to select randomized clinical trials, observational studies, or case series that evaluated outcome measures after physical activity. Twenty randomized controlled trials (RCTs) and two case series were included in this review. Four trials were at low risk of bias (A), 12 at unclear risk of bias (B), and four at high risk of bias (C). Compared to controls, Aquatic Exercise, Land-based Exercise, Tai Chi, and Yoga showed a small to high effect for improving pain, physical function, quality of life, and stiffness. Active exercise and sport are effective to improve pain and physical function in elderly people with osteoarthritis. Nevertheless, further studies are required to validate the use of land-based exercise, aquatic exercise, or sport to treat the symptoms of older adults that suffer from knee and hip osteoarthritis.

Highlights

Osteoarthritis (OA) is a chronic progressive disease that represents a considerable cause of impairment in elderly people [1]
One hundred sixty-nine articles were read in full text, and 147 of those were excluded for the following reasons: not mainly evaluating physical activity intervention (n = 45), patients aged less than 65 years (n = 67), not specified joints that suffered from OA (n = 14), protocols of randomized controlled trials (RCTs) (n = 18), and case reports (n = 3)
45), patients aged less than 65 years (n = 67), not specified joints that suffered from OA (n ocols of RCT (n = 18), and case reports (n = 3)

Summary

Introduction

Osteoarthritis (OA) is a chronic progressive disease that represents a considerable cause of impairment in elderly people [1] It is characterized by pain, reduction of physical function with decreased range of motion (ROM), joint rigidity and swelling, muscle weakness, and joint instability [2,3]. All these conditions lead to impaired quality of life with worsening to achieve daily activities and disability, especially in older adults [4]. We focused our research on active exercise and sports that have been determined to be effective in pain relief, maintenance of joint integrity, and muscle strength, improvement in physical function, and lessening deformity and instability [13]. The secondary endpoint is to establish the specific benefits on the selected outcomes of the single intervention, to try to evaluate if there is an exercise or sport that leads to better enhancement in physical capacity and quality of life of older osteoarthritic adults

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