SynthesisRMD open2026
Effectiveness of exercise therapy for osteoarthritis: an overview of systematic reviews and randomised controlled trials.
Synthesis in RMD open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
4 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Barriers to and facilitators of maintaining physical activity for people with hip and knee osteoarthritis: a mixed-methods systematic review.Rheumatology international · 2026Pooled it
- Effects of aquatic exercise on pain and physical function in overweight/obese patients with lower limb osteoarthritis: a systematic review and meta-analysis.Frontiers in physiology · 2026Pooled it
- Effects of a Cycling-Based Aerobic Exercise Program Versus a Resistance and Neuromuscular Exercise Program on Exercise-Induced Hypoalgesia in Knee Osteoarthritis: A Study Protocol for a Randomized Clinical Trial.Physiotherapy research international : the journal for researchers and clinicians in physical therapy · 2026Article
- Small but relevant effects of exercise therapy in osteoarthritis.Nature reviews. Rheumatology · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo provide an overview of the effects of exercise for osteoarthritis.
designOverview. DATA SOURCES: Medline, Embase, Epistemonikos, PEDro, Cochrane and registries from inception to 8 November 2025. ELIGIBILITY CRITERIA: Reviews comparing exercise with placebo, no intervention or other interventions on pain and function for osteoarthritis. Supplementary trials were included to update inconclusive areas. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers extracted data and assessed bias. Data were standardised to a 0-100 scale and reanalysed using random-effects meta-analysis. Certainty was rated using Grading of Recommendations Assessment, Development and Evaluation.
resultsFive reviews (κ=100; n=8631) and 28 supplementary trials (knee/hip κ=23, hand κ=3, ankle κ=2; n=4360) were included. Evidence indicated small, short-term effects of exercise versus placebo (mean difference -10.8, 95% CI -19.1 to -2.6) and no-treatment (-12.4, 95% CI -15.6 to -9.2) for knee osteoarthritis pain, but certainty was very low and effects in larger or longer-term trials were smaller. Moderate evidence suggested negligible effects in hip (-6.7 95% CI -9.3 to -4.0) and small effects in hand (-10.0 95% CI -15.5 to -4.5) osteoarthritis. Varying certainty evidence indicated comparable outcomes to education, manual therapy, analgesics, injections and arthroscopy. Single trials in selected populations showed exercise was less effective than knee osteotomy (12.4 95% CI 4.7 to 20.2) and joint replacement (knee 17.1 95% CI 10.4 to 23.8; hip 24.2 95% CI 18.2 to 30.2) at longer term. CONCLUSION AND RELEVANCE: Evidence on exercise for osteoarthritis remains largely inconclusive, suggesting negligible or short-lasting small effects comparable to, or less effective than, other treatments. These findings question its universal promotion and highlight the need to revisit research priorities and clinical discussions around its worthwhileness. REGISTRATION: CRD42023446888.
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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.