Aerobic Exercise Found to be Most Beneficial in Managing Knee Osteoarthritis

According to a recent systematic review and network meta-analysis, aerobic exercise has been found to be the most beneficial treatment for managing knee osteoarthritis. The study, conducted by researchers from Zhejiang University School of Medicine, included 217 randomised controlled trials involving 15,684 participants. The results showed that aerobic exercise resulted in significant improvements in pain, function, gait performance, and quality of life, with moderate certainty evidence.

Key Takeaways:

• Aerobic exercise probably results in large improvements in pain at short term (standardised mean difference -1.10, 95% confidence interval -1.68 to -0.52) and mid-term follow-up (-1.19, -1.59 to -0.79).
• Aerobic exercise probably results in a large increase in function at mid-term (1.78, 1.05 to 2.51) and quality of life at short term (1.53, 0.47 to 2.59).
• Mind-body exercise probably results in a large increase in function at short term follow-up (0.88, 0.03 to 1.73; moderate certainty), while neuromotor exercise probably results in a large increase in gait performance at short term follow-up (1.04, 0.51 to 1.57; moderate certainty).
• Strengthening and mixed exercise probably result in a large increase in function at mid-term follow-up, all with moderate certainty evidence.
• Regarding long term follow-up, flexibility exercise may result in a large reduction in pain (-0.99, -1.63 to -0.36; low certainty); aerobic exercise may result in a large increase in function (0.87, 0.02 to 1.72, low certainty); and mixed exercise may increase function (0.56, 0.26 to 0.86; low certainty) and probably increases gait performance (0.57, 0.21 to 0.92, moderate certainty).
• Aerobic exercise consistently showed the highest probability of being the best treatment, as reflected by surface under the cumulative ranking curve values (mean 0.72) across outcomes.

Statistics:

• 217 randomised controlled trials involving 15,684 participants were included in the study.
• Aerobic exercise resulted in a standardised mean difference of -1.10 (95% confidence interval -1.68 to -0.52) in pain reduction at short term follow-up.
• Aerobic exercise resulted in a standardised mean difference of 1.78 (95% confidence interval 1.05 to 2.51) in function improvement at mid-term follow-up.

Sources:

• Comparative efficacy and safety of exercise modalities in knee osteoarthritis: systematic review and network meta-analysis. BMJ, 2025;391.
• NewsRx. Researchers from Zhejiang University School of Medicine Provide Details of New Studies and Findings in the Area of Knee Osteoarthritis (Comparative efficacy and safety of exercise modalities in knee osteoarthritis: systematic review and network ...). Health & Medicine Week. October 31, 2025; p 6932.