Trial reportAnnals of internal medicine2021
Stepped Exercise Program for Patients With Knee Osteoarthritis : A Randomized Controlled Trial.
Trial report in Annals of internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02653768 (STepped Exercise Program for Knee Osteoarthritis), which is not on this map. Cited by 47 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
STepped Exercise Program for Knee Osteoarthritis (STEP-KOA)
Who cites it
47 citing papers in PubMed, 8 syntheses or guidelines pooled it, 86 citations in OpenAlex.
- Pooled it
- The efficacy and safety of pilates exercise in patients with knee osteoarthritis: a systematic review with meta-analysis of randomized controlled trials.Annals of medicine · 2025Pooled it
- Exercise for osteoarthritis of the knee.The Cochrane database of systematic reviews · 2024Pooled it
- Effectiveness of Internet-Based Telehealth Programs in Patients With Hip or Knee Osteoarthritis: Systematic Review and Meta-Analysis.Journal of medical Internet research · 2024Pooled it
- Telehealth-Supported Exercise or Physical Activity Programs for Knee Osteoarthritis: Systematic Review and Meta-Analysis.Journal of medical Internet research · 2024Pooled it
- EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis: 2023 update.Annals of the rheumatic diseases · 2024Guideline
- Benefits and Harms of Digital Health Interventions Promoting Physical Activity in People With Chronic Conditions: Systematic Review and Meta-Analysis.Journal of medical Internet research · 2023Pooled it
- CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2022Guideline
- Effectiveness of the Self-Directed mHealth Exercise Intervention re.flex in Patients With Knee Osteoarthritis: Randomized Controlled Trial.Journal of medical Internet research · 2025Trial
- Experiences and perceptions of Chinese patients enrolled in a clinical trial assessing tuina and manual therapies for knee osteoarthritis: a nested qualitative study.BMC complementary medicine and therapies · 2025Trial
- Physical therapy vs. glucocorticoid injection in patients with meniscal tears and knee osteoarthritis: a multi-center, randomized, controlled trial.BMC medicine · 2025Trial
- Home-Based Shi's Knee Daoyin Exercise for Knee Osteoarthritis: A Randomized Controlled Pilot Trial.Journal of pain research · 2024Trial
- The Efficacy of Acupuncture, Exercise Rehabilitation, and Their Combination in the Treatment of Knee Osteoarthritis: A Randomized Controlled Trial.Journal of pain research · 2024Trial
- Osteoarthritis: Epidemiology, Diagnosis, and Treatment.MedComm · 2026Review
- Comment on "Relationship of strength training lifetime exposure with functional outcomes and mobility over 4 years: Data from the Osteoarthritis Initiative".Journal of sport and health science · 2026Article
- Therapeutic Patient Education in Adults with Chronic Lower Limb Musculoskeletal Pain: A Scoping Review.Healthcare (Basel, Switzerland) · 2026Review
- App-based exercise intervention versus supervised exercise therapy for patients with hip or knee osteoarthritis-the randomised noninferiority DigiOA trial.EULAR rheumatology open · 2025Article
- Relationship of total and regional lean body mass with knee pain and function in patients with knee osteoarthritis: a cross-sectional study.BMC musculoskeletal disorders · 2025Article
- Efficacy and Safety of Acupuncture at Sensitized Acupoints for Knee Osteoarthritis: Protocol for a Multicenter, Single-Blind Randomized Controlled Trial.JMIR research protocols · 2025Article
- Efficacy of Tuina Therapy Based on Hip-Knee-Ankle Synergy in the Lower Extremity Kinematic Chain in Patients With Knee Osteoarthritis: Protocol for a Randomized Controlled Trial.JMIR research protocols · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundEvidence-based models are needed to deliver exercise-related services for knee osteoarthritis efficiently and according to patient needs
objectiveTo examine a stepped exercise program for patients with knee osteoarthritis (STEP-KOA).
designRandomized controlled trial. (ClinicalTrials.gov: NCT02653768).
setting2 U.S. Department of Veterans Affairs sites.
participants345 patients (mean age, 60 years; 15% female; 67% people of color) with symptomatic knee osteoarthritis.
interventionParticipants were randomly assigned in a 2:1 ratio to STEP-KOA or an arthritis education (AE) control group, respectively. The STEP-KOA intervention began with 3 months of an internet-based exercise program (step 1). Participants who did not meet response criteria for improvement in pain and function after step 1 progressed to step 2, which involved 3 months of biweekly physical activity coaching calls. Participants who did not meet response criteria after step 2 went on to in-person physical therapy visits (step 3). The AE group received educational materials via mail every 2 weeks. MEASUREMENTS: Primary outcome was Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. Scores for the STEP-KOA and AE groups at 9 months were compared by using linear mixed models.
resultsIn the STEP-KOA group, 65% of participants (150 of 230) progressed to step 2 and 35% (81 of 230) to step 3. The estimated baseline WOMAC score for the full sample was 47.5 (95% CI, 45.7 to 49.2). At 9-month follow-up, the estimated mean WOMAC score was 6.8 points (CI, -10.5 to -3.2 points) lower in the STEP-KOA than the AE group, indicating greater improvement. LIMITATION: Participants were mostly male veterans, and follow-up was limited.
conclusionVeterans in STEP-KOA reported modest improvements in knee osteoarthritis symptoms compared with the control group. The STEP-KOA strategy may be efficient for delivering exercise therapies for knee osteoarthritis. PRIMARY FUNDING SOURCE: Department of Veterans Affairs, Health Services Research and Development Service.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.