ArticleArthritis care & research2023
How Do Nonsurgical Interventions Improve Pain and Physical Function in People With Osteoarthritis? A Scoping Review of Mediation Analysis Studies.
Article in Arthritis care & research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
What it found
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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.
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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.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Exercise for osteoarthritis of the knee.The Cochrane database of systematic reviews · 2024Pooled it
- Injury Prevention Programmes Fail to Change Most Lower Limb Kinematics and Kinetics in Female Team Field and Court Sports: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.Sports medicine (Auckland, N.Z.) · 2024Pooled it
- Moderators and Mediators of Pain and Function Outcomes in a New Service Delivery Model for Management of Knee Osteoarthritis in Primary Care: Secondary Exploratory Analysis of a Randomized Controlled Trial.Arthritis care & research · 2025Trial
- How Does Exercise, With and Without Diet, Improve Pain and Function in Knee Osteoarthritis? A Secondary Analysis of a Randomized Controlled Trial Exploring Potential Mediators of Effects.Arthritis care & research · 2023Trial
- Enhancing physical activity and reducing symptoms of patients with osteoarthritis of the knee: a randomized controlled trial of the PrevOP-Psychological Adherence Program.BMC musculoskeletal disorders · 2023Trial
- Determining optimal diet/exercise treatment assignment for patients with symptomatic knee osteoarthritis using baseline gait forces.Osteoarthritis and cartilage open · 2025Article
- Co-development of an evidence-informed, theoretically driven exercise programme for people with chronic non-specific neck pain (the EPIC-Neck programme - "Exercise Prescription Improved through Co-design").BMC musculoskeletal disorders · 2025Article
- The Impact of Strength/Resistance Training on Related Outcomes of Patients with Knee Osteoarthritis: A Systematic Review and Meta-Analysis Study : Strength/Resistance Training in Knee Osteoarthritis.Galen medical journal · 2025Article
- Mediators of the effects of exercise and manual therapy for people with knee and hip osteoarthritis: A secondary, exploratory analysis of the MOA trial.Osteoarthritis and cartilage open · 2024Article
- "Restoring That Faith in My Shoulder": A Qualitative Investigation of How and Why Exercise Therapy Influenced the Clinical Outcomes of Individuals With Rotator Cuff-Related Shoulder Pain.Physical therapy · 2023Article
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveNonsurgical interventions are recommended for osteoarthritis (OA). However, how interventions change pain and physical function is unclear. Therefore, the objectives of this scoping review were to 1) identify what potential mediators of nonsurgical interventions on pain and physical function have been evaluated and 2) summarize the findings according to intervention, joint, and outcome.
methodsWe searched Medline, Embase, CINAHL, Cochrane Central Register of Controlled Trials, and Scopus databases. Studies were included if they conducted a mediation analysis on a randomized controlled trial evaluating a nonsurgical intervention on OA of any joint. Outcomes were pain and physical function.
resultsNine knee OA studies, evaluating diet plus exercise, exercise, unloading shoes, high-expectation communication during acupuncture, and telephone-based weight loss plus exercise were identified. Except for weight loss and self-efficacy, putative mediators (knee muscle perfusion/extensor strength/adduction moment, systemic inflammatory biomarkers, physical activity, dietary intake, and pain beliefs) were evaluated by single studies. Ten mediators partially mediated intervention (diet plus exercise, exercise, high-expectation communication) effects on pain and physical function. Eight mediators were common to pain and function (reduced weight, increased knee extensor strength, and increased self-efficacy). Constant knee flexor muscle perfusion partially mediated exercise effects on pain, and knee pain relief partially mediated exercise effects on function.
conclusionIn knee OA, some evidence suggests that the benefits of 1) diet and exercise are mediated through changes in body weight, systemic inflammation, and self-efficacy; 2) exercise is mediated through changes in knee muscle strength and self-efficacy; and 3) high-expectation communication style is mediated through changes in self-efficacy.
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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.