Proprioceptive Training for Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials


Author: Yi Wang1, Zugui Wu1, Zehua Chen1, Xiangling Ye1, Guoqian Chen2, Jiaman Yang1, Peiming Zhang3, Fang Xie4, Yingxin Guan1, Jiatao Wu1, Weijian Chen1, Zixuan Ye1, Xuemeng Xu1,5

Affiliation: <sup>1</sup> The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China.

<sup>2</sup> Department of Orthopaedic Surgery, Zhejiang Provincial Hospital of Chinese Medicine, Hangzhou, China.

<sup>3</sup> Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China.

<sup>4</sup> Affiliated Changde Hospital, Hunan University of Traditional Chinese Medicine, Changde, China.

<sup>5</sup> Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China.
Conference/Journal: Front Med (Lausanne)
Date published: 2021 Oct 28
Other:
 Volume ID: 8   ,  Pages: 699921   ,  Special Notes: doi: 10.3389/fmed.2021.699921.   ,  Word Count: 378  
    Background: There is increased interest in proprioceptive training for knee osteoarthritis (KOA). However, little consensus supports the effectiveness of this intervention. Objective: This meta-analysis aimed to assess the effects of proprioceptive training on symptoms, function, and proprioception in people with KOA. Methods: The PubMed, Cochrane Library, Web of Science, and EMBASE databases were systematically searched from the inception dates to April 16, 2021 for relevant randomized controlled trials (RCTs). Data were pooled by calculating the standardized mean differences (SMDs) and 95% confidence intervals (CIs). A random-effects model was used for the analyses. Results: A total of 24 RCTs involving 1,275 participants were included in our analysis. This study indicated that compared to no intervention, proprioceptive training significantly improved pain, stiffness, physical function, joint position sense (JPS), muscle strength, mobility, and knee ROM (P < 0.05) in people with KOA. When compared to other non-proprioceptive training, proprioceptive training provided better results in terms of JPS (SMD = -1.28, 95%CI: [-1.64, -0.92], I 2 = 0%, P < 0.00001) and mobility (timed walk over spongy surface) (SMD = -0.76, 95%CI: [-1.33, -0.18], I 2 = 64%, P = 0.01), and other results are similar. When proprioceptive training plus other non-proprioceptive training compared to other non-proprioceptive training, the two groups showed similar outcomes, but there was a greater improvement for JPS (SMD = -1.54, 95%CI: [-2.74, -0.34], I 2 = 79%, P = 0.01), physical function (SMD = -0.34, 95%CI: [-0.56, -0.12], I 2 = 0%, P = 0.003), and knee ROM (P < 0.05) in the proprioceptive training plus other non-proprioceptive training group. When proprioceptive training plus conventional physiotherapy compared against conventional physiotherapy, the two groups demonstrated similar outcomes, but there was a significant improvement for JPS (SMD = -0.95, 95%CI: [-1.73, -0.18], I 2 = 78%, P = 0.02) in the proprioceptive training plus conventional physiotherapy group. Conclusions: Proprioceptive training is safe and effective in treating KOA. There is some evidence that proprioceptive training combined with general non-proprioceptive training or conventional physiotherapy appears to be more effective and should be considered as part of the rehabilitation program. However, given that the majority of current studies investigated the short-term effect of these proprioceptive training programs, more large-scale and well-designed studies with long-term follow up are needed to determine the long-term effects of these proprioceptive training regimes in KOA. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/#recordDetails, PROSPERO, identifier: CRD42021240587.



Keywords: knee osteoarthritis; meta-analysis; proprioceptive training; rehabilitation; systematic review.



PMID: 34778281 PMCID: PMC8581183 DOI: 10.3389/fmed.2021.699921