People with short symptom duration of knee osteoarthritis benefit more from exercise therapy than people with longer symptom duration: An individual participant data meta-analysis from the OA trial bank.

van Middelkoop, M; Schiphof, D; Middelkoop M, van; Hattle, M; D, Schiphof; Simkins, J; M, Hattle; Bennell, K L; J, Simkins; Hinman, R S; KL, Bennell; Allen, K D; RS, Hinman; Knoop, J; KD, Allen; van Baar, M E; J, Knoop; Bossen, D; Baar ME, van; Wallis, J; D, Bossen; Hurley, M; J, Wallis; Holden, M A; M, Hurley; Bierma-Zeinstra, S M A; MA, Holden; SMA, Bierma-Zeinstra

Abstract

To investigate whether duration of knee symptoms influenced the magnitude of the effect of exercise therapy compared to non-exercise control interventions on pain and physical function in people with knee osteoarthritis (OA). We undertook an individual participant data (IPD) meta-analysis utilising IPD stored within the OA Trial Bank from randomised controlled trials (RCTs) comparing exercise to non-exercise control interventions among people with knee OA. IPD from RCTs were analysed to determine the treatment effect by considering both study-level and individual-level covariates in the multilevel regression model. To estimate the interaction effect (i.e., treatment x duration of symptoms (dichotomised)), on self-reported pain or physical function (standardised to 0-100 scale), a one-stage multilevel regression model was applied. We included IPD from 1767 participants with knee OA from 10 RCTs. Significant interaction effects between the study arm and symptom duration (≤1 year vs >1 year, and ≤2 years vs>2 years) were found for short- (~3 months) (Mean Difference (MD) -3.57, 95%CI -6.76 to -0.38 and -4.12, 95% CI-6.58 to -1.66, respectively) and long-term (~12 months) pain outcomes (MD -8.33, 95%CI -12.51 to -4.15 and -8.00, 95%CI -11.21 to -4.80, respectively), and long-term function outcomes (MD -5.46, 95%CI -9.22 to -1.70 and -4.56 95%CI -7.33 to-1.80, respectively). This IPD meta-analysis demonstrated that people with a relatively short symptom duration benefit more from therapeutic exercise than those with a longer symptom duration. Therefore, there seems to be a window of opportunity to target therapeutic exercise in knee OA. [Abstract copyright: Copyright © 2024. Published by Elsevier Ltd.]

Citation

van Middelkoop, M., Schiphof, D., Middelkoop M, V., Hattle, M., D, S., Simkins, J., M, H., Bennell, K. L., J, S., Hinman, R. S., KL, B., Allen, K. D., RS, H., Knoop, J., KD, A., van Baar, M. E., J, K., Bossen, D., Baar ME, V., Wallis, J., …SMA, B.-Z. (2024). People with short symptom duration of knee osteoarthritis benefit more from exercise therapy than people with longer symptom duration: An individual participant data meta-analysis from the OA trial bank. Osteoarthritis and Cartilage, https://doi.org/10.1016/j.joca.2024.07.007

• Journal Article Type: Article
• Acceptance Date: Jul 15, 2024
• Online Publication Date: Jul 18, 2024
• Publication Date: 2024-07
• Deposit Date: Aug 12, 2024
• Journal: Osteoarthritis and cartilage
• Print ISSN: 1063-4584
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1016/j.joca.2024.07.007
• Keywords: Knee, Osteoarthritis, Moderation, Exercise
• Public URL: https://keele-repository.worktribe.com/output/883332
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S106345842401313X?via%3Dihub
• PMID: 39032625