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In older people with knee osteoarthritis, stretching exercise programs can improve pain, stiffness, and physical function disability

Zhu GC, Chen KM, Belcastro F. Comparing Different Stretching Exercises on Pain, Stiffness, and Physical Function Disability in Older Adults With Knee Osteoarthritis. Arch Phys Med Rehabil. 2023 Jul 17:S0003-9993(23)00405-7.

Review question

In older people with knee osteoarthritis, do stretching exercise programs help manage pain, stiffness, and physical function disability?

Background

Knee osteoarthritis causes pain and stiffness of the knee and can reduce an older person’s ability to perform activities of daily living and live independently.

It is not known if stretching exercise programs can improve the symptoms of knee osteoarthritis in older people.

How the review was done

The researchers did a systematic review of studies available up to December 2022. They found 17 randomized controlled trials that included a total of 1,785 people.

Key features of the studies were

• number of people in the studies ranged from 26 to 350;
• average age was 65 to 74 years, and most people were women;
• therapy was provided for 4 weeks to 6 months;
• therapy could be proprioceptive neuromuscular facilitation (assisted stretching or muscle contraction against resistance), mind–body exercises (e.g., yoga, Tai-chi Qigong, Baduanjin), or multi-component exercise programs;
• all exercises programs included muscle strengthening and stretching; and
• therapy was compared with no stretching exercise, an exercise program that did not involve stretching, health education, acupuncture, or usual care.

What the researchers found

Pain

Proprioceptive neuromuscular facilitation reduced pain by a large amount compared with multi-component exercise and compared with control.

Mind–body exercise reduced pain by a large amount compared with control.

Multi-component exercise reduced pain by a moderate amount compared with control.

Stiffness

Mind–body exercise reduced stiffness by a large amount compared with control.

Physical function disability

Multi-component exercise reduced physical function disability by a large amount compared with control.

Conclusion

In older people with knee osteoarthritis, different types of stretching exercise programs can improve pain, stiffness, and physical function disability.

Effects of stretching exercise programs vs control in older people with knee osteoarthritis

*Amount of improvement with stretching exercise programs is based on standardized mean differences (SMDs), where SMD < 0.50 = small improvement; SMD 0.50 to 0.79 = moderate improvement; SMD ≥ 0.80 = large improvement.