Comparing Different Stretching Exercises on Pain, Stiffness, and Physical Function Disability in Older Adults with Knee Osteoarthritis


Author: Guan-Cheng Zhu1, Kuei-Min Chen2, Frank Belcastro3

Affiliation: <sup>1</sup> Postdoctoral Fellow; Center for Long-Term Care Research, Kaohsiung Medical University; 100 Shih-Chuan 1(st) Rd., Sanmin District, Kaohsiung, Taiwan 80708. Electronic address: r110343@kmu.edu.tw.

<sup>2</sup> Professor; College of Nursing, Kaohsiung Medical University; 100 Shih-Chuan 1(st) Rd., Sanmin District, Kaohsiung, Taiwan 80708; Center for Long-Term Care Research, Kaohsiung Medical University; Department of Medical Research, Kaohsiung Medical University Hospital. Electronic address: kmc@kmu.edu.tw.

<sup>3</sup> Professor; Department of Education and Psychology, University of Dubuque; 2000 University Ave., Dubuque, Iowa 52001, USA. Electronic address: fpbelcast@gmail.com.
Conference/Journal: Arch Phys Med Rehabil
Date published: 2023 Jul 17
Other:
  Special Notes: doi: 10.1016/j.apmr.2023.07.001.   ,  Word Count: 236  
    Objective:

To assess and compare the effects of different stretching exercise programs on pain, stiffness, and physical function disability in older adults with knee osteoarthritis (KOA).



Data sources:

This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline for network meta-analysis (NMA). Relevant randomized controlled trials (RCTs) were identified by searching seven databases up to December 2022.



Study selection:

Inclusion criteria included: (1) older adults with KOA; (2) intervention included stretching exercises; (3) control groups received no stretching exercise; and (4) outcome measurements included pain, stiffness, or physical function disability. Methodological quality was assessed using the Cochrane risk-of-bias tool for randomized trials version 2 (RoB2).



Data extraction:

NMA was performed using R and MetaInsight, with results presented as a standardized mean difference (SMD) with 95% confidence interval (CI).



Data synthesis:

We examined 17 studies, and NMA results indicated that proprioceptive neuromuscular facilitation (PNF) stretching, mind-body exercises, and multi-component exercise programs were effective in mitigating pain in older adults with KOA (SMD = 2.54 [95% CI: 1.23; 3.84], SMD = 1.09 [95% CI: 0.27; 1.92], SMD = 0.57 [95% CI: 0.06; 1.09]). Moreover, mind-body exercises and multi-component exercises were the most effective programs in reducing stiffness (SMD = 1.31 [95% CI: 0.12; 2.51]) and physical function disability (SMD = 1.67 [95% CI: 0.01; 3.33]) in older adults with KOA, respectively.



Conclusion:

Findings suggest that PNF stretching, mind-body exercises, and multi-component exercises can be incorporated into exercise programs to better mitigate pain, stiffness, and physical function disability in older adults with KOA.



Keywords: Knee osteoarthritis; Network Meta-analysis; Older adults; Stretching Exercises; Systematic review.



PMID: 37467937 DOI: 10.1016/j.apmr.2023.07.001