Exercise is good! But not that good!! Atleast for some pains and patients!!!

Rewriting recommendations

Can exercise really ease knee pain?

Movement is medicine, or so they tell people with knee osteoarthritis—but are they right?

A recent evidence review calls into question just how helpful exercise can be for easing the pain of knee arthritis.

"Exercise probably results in an improvement in pain, physical function, and quality of life in the short‐term," concluded the research team who tested this theory.

"However, based on the thresholds for minimal important differences that we used, these benefits were of uncertain clinical importance," the team added in its report published previously in the Cochrane Library.

The review casts a slight shadow on what has been considered an integral part of therapy for knee pain.

Movement is an essential part of an osteoarthritis treatment plan," the Arthritis Foundation says on its website, recommending that people take part in strength training, stretching, aerobics, and balance exercises.

For the new review, the team evaluated data from 139 prior clinical trials involving nearly 12,500 participants that occurred up through early Jan. 2024.

On a 100-point scale, exercise for knee arthritis improved:

• Pain by 8.7 to 13.1 points
• Physical function by 9.7 to 12.5 points
• Quality of life by 4.2 to 6.1 points

But while those were significant improvements, they did not always meet established scores for making a minimal important difference in a patient's life, researchers noted.

For exercise to have a meaningful contribution, pain would need to improve by 12 points, physical function by 13 points, and quality of life by 15 points.

"The benefits were of uncertain clinical importance, meaning that they may not result in a change in symptoms that makes a noticeable difference to patients," the research team wrote.

The review team also noted that many of the studies in their review included small groups or were not well-designed.

"Many studies are of poor quality with small sample sizes," the researchers wrote. "Therefore, some studies may have made the benefits of exercise seem greater than they are."

Authors' conclusions

We found low‐ to moderate‐certainty evidence that exercise probably results in an improvement in pain, physical function, and quality of life in the short‐term. However, based on the thresholds for minimal important differences that we used, these benefits were of uncertain clinical importance. Participants in most trials were not blinded and were therefore aware of their treatment, and this may have contributed to reported improvements.

Placebo effect?

What?!

Exercise is good! But not that good!! Atleast for some pains and patients!!!

Belinda J Lawford et al. Exercise for osteoarthritis of the knee, Cochrane Database of Systematic Reviews (2024). DOI: 10.1002/14651858.CD004376.pub4