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Impact or No Impact for Women With Mild Knee Osteoarthritis: A Bayesian Meta‐Analysis of Two Randomized Controlled Trials With Contrasting Interventions
Author(s) -
Heikkinen Risto,
Waller Benjamin,
Munukka Matti,
Multanen Juhani,
Hein Ari,
Karvanen Juha
Publication year - 2022
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.24553
Subject(s) - cardiorespiratory fitness , randomized controlled trial , physical therapy , psychological intervention , isometric exercise , physical medicine and rehabilitation , meta analysis , osteoarthritis , medicine , psychology , surgery , alternative medicine , pathology , psychiatry
Objective To predict the probability of a benefit from 2 contrasting exercise programs for women with a new diagnosis of mild knee osteoarthritis, and to estimate the short‐ and long‐term effects of aquatic resistance training (ART) and high‐impact aerobic land training (HLT) compared with a control. Methods Original data sets from 2 previously conducted randomized controlled trials were combined and used in a Bayesian meta‐analysis. Group differences in multiple response variables were estimated. Variables included cardiorespiratory fitness, dynamic maximum leg muscle power, maximal isometric knee extension and flexion force, pain, other symptoms, and quality of life. The statistical model included a latent commitment variable for each female participant. Results ART had a 55–71% probability of benefits in the outcome variables, and as the main effect, the intervention outperformed the control in cardiorespiratory fitness, with a probability of 71% immediately after the intervention period. HLT had a 46–63% probability of benefits after intervention with the outcome variables, but differently from ART; the positive effects of physical performance fade away during the follow‐up period. Overall, the differences between groups were small, and the variation in the predictions between individuals was high. Conclusion Both interventions had benefits, but ART has a slightly higher probability of long‐term benefits on physical performance. Because of high individual variation and no clear advantage of one training method over the other, personal preferences should be considered in the selection of the exercise program to ensure highest commitment to training.