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Osteoarthritis is a major contributor to pain and disability, and while ample evidence suggests that exercise and manual therapy are beneficial for improving pain and function of sufferers, the body of research lacks evidence comparing the different intervention types. A systematic review with meta-analysis was performed to determine the effect of strength training, multimodal exercise therapy and manual mobilization on pain and physical function in people with osteoarthritis of the knee. A search of MEDLINE, PEDro, and CINAHL was performed (January 2009 – May 2014). Trials incorporating either strength training alone, multi-modal exercise (strength training and active range of motion exercises with or without aerobic activity) or exercise plus additional manual mobilization were included. Meta-analyses were performed for each intervention type and both pain and physical function outcome measures. Results: Data from eight eligible studies was integrated. The search did not reveal trials comparing the effects of manual mobilization and exercise therefore this comparison could not be analyzed. Strength training demonstrated a larger effect Anna Frances Quillfeldt1, Rebecca Melissa Marks1 Affiliations: 1BClinSc, MOstMed, School of Health and Human Sciences, Southern Cross University, Lismore, NSW, Australia. Corresponding Author: Anna Frances Quillfeldt, C/O Julie Streckfuss, School of Health and Human Sciences, Southern Cross University, PO Box 157, Lismore, NSW, Australia, 2480; Email: a.quillfeldt.10@gmail.com Received: 29 February 2016 Accepted: 06 April 2016 Published: 30 April 2016 size [pain = 1.26 (95% CI 0.97 to 1.55); physical function =1.15 (95% CI 0.87 to 1.44)] compared to multi-modal exercise [pain = 0.47 (95% CI 0.24 to 0.69); physical function = 0.53 (95% CI 0.30 to 0.75)]. In conclusion, Strength training and multi-modal exercise were both found to be effective in reducing pain and improving physical function in people with osteoarthritis of the knee. Strength training alone revealed more favorable effect sizes than multi-modal exercise.

edorium journal of disability and rehabilitation

Effects of strength training, multimodal exercise and manual mobilization on pain and function in knee osteoarthritis: A systematic review and meta-analysis