Author: Guan-Cheng Zhu1, Kuei-Min Chen2, Frank Belcastro3
1 Postdoctoral Fellow; Center for Long-Term Care Research, Kaohsiung Medical University; 100 Shih-Chuan 1(st) Rd., Sanmin District, Kaohsiung, Taiwan 80708. Electronic address: firstname.lastname@example.org.
2 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: email@example.com.
3 Professor; Department of Education and Psychology, University of Dubuque; 2000 University Ave., Dubuque, Iowa 52001, USA. Electronic address: firstname.lastname@example.org.
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
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).
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.
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).
NMA was performed using R and MetaInsight, with results presented as a standardized mean difference (SMD) with 95% confidence interval (CI).
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.
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