Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Systematic Reviews
Published in: Systematic Reviews 1/2016

Open Access 01-12-2016 | Protocol

Relative efficacy of different types of exercise for treatment of knee and hip osteoarthritis: protocol for network meta-analysis of randomised controlled trials

Authors: Siew-Li Goh, Monica S. M. Persson, Archan Bhattacharya, Michelle Hall, Michael Doherty, Weiya Zhang

Published in: Systematic Reviews | Issue 1/2016

Login to get access

Abstract

Background

‘Exercise’ is universally recommended as a core treatment for knee and hip osteoarthritis (OA). However, there are very few head-to-head comparative trials to determine the relative efficacy between different types of exercise. The aim of this study is to benchmark different types of exercises against each other through the use of a common comparator in a network meta-analysis of randomised controlled trials (RCTs).

Methods

This study will include only RCTs published in peer-reviewed journals. A systematic search will be conducted in several electronic databases and other relevant online resources. No limitations are imposed on language or publication date. Participants must be explicitly identified by authors as having OA. Interventions that involved exercise or comparators in any form will be included. Pain is the primary outcome of interest; secondary outcomes will include function and quality of life measures. Quality assessment of studies will be based on the modified Cochrane’s risk of bias assessment tool. At least two investigators will be involved throughout all stages of screening and data acquisition. Conflicts will be resolved through discussion. Conventional meta-analysis will be performed based on random effects model and network meta-analysis on a Bayesian model. Subgroup analysis will also be conducted based on study, patient and disease characteristics.

Discussion

This study will provide for the first time comprehensive research evidence for the relative efficacy of different exercise regimens for treatment of OA. We will use network meta-analysis of existing RCT data to answer this question.

Systematic review registration

Appendix
Available only for authorised users
Literature
1.
2.
Busija L, Bridgett L, Williams SRM, Osborne RH, Buchbinder R, March L, Fransen M. Osteoarthritis. Best Pract Res Cl Rh. 2010;24(6):757–68.CrossRef
3.
Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2163–96.CrossRefPubMed
4.
Laslett LL, Quinn SJ, Winzenberg TM, Sanderson K, Cicuttini F, Jones G. A prospective study of the impact of musculoskeletal pain and radiographic osteoarthritis on health related quality of life in community dwelling older people. BMC Musculoskel Dis. 2012;13(1):1.CrossRef
5.
6.
Lee YH, Woo J-H, Choi SJ, Ji JD, Song GG. Effect of glucosamine or chondroitin sulfate on the osteoarthritis progression: a meta-analysis. Rheumatol Int. 2010;30(3):357–63.CrossRefPubMed
7.
Wandel S, Jüni P, Tendal B, Nüesch E, Villiger PM, Welton NJ, Reichenbach S, Trelle S. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis. BMJ (Overseas & Retired Doctors Edition). 2010;341(7775):c4675.
8.
McAlindon T, Bannuru R, Sullivan M, Arden N, Berenbaum F, Bierma-Zeinstra S, Hawker G, Henrotin Y, Hunter D, Kawaguchi H. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthr Cartilage. 2014;22(3):363–88.CrossRef
9.
Hochberg MC, Altman RD, April KT, Benkhalti M, Guyatt G, McGowan J, Towheed T, Welch V, Wells G, Tugwell P. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthrit Care Res. 2012;64(4):465–74.CrossRef
10.
Zhang W, Nuki G, Moskowitz RW, Abramson S, Altman RD, Arden NK, Bierma-Zeinstra S, Brandt KD, Croft P, Doherty M, et al. OARSI recommendations for the management of hip and knee osteoarthritis: part III: changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthr Cartilage. 2010;18(4):476–99.CrossRef
11.
Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA, Minson CT, Nigg CR, Salem GJ, Skinner JS. Exercise and physical activity for older adults. Med Sci Sport Exer. 2009;41(7):1510–30.CrossRef
12.
Kaminsky LA. ACSM’s health related physical fitness assessment manual. Philadelphia, PA: Wolters Kluwer Health, Lippincott Williams & Wilkins; 2014.
13.
Pisters MF, Veenhof C, Van Meeteren NL, Ostelo RW, De Bakker DH, Schellevis FG, Dekker J. Long‐term effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: a systematic review. Arthrit Care Res. 2007;57(7):1245–53.CrossRef
14.
Juhl C, Christensen R, Roos EM, Zhang W, Lund H. Impact of exercise type and dose on pain and disability in knee osteoarthritis: a systematic review and meta-regression analysis of randomized controlled trials. Arthritis Rheum. 2014;66(3):622–36.CrossRef
15.
Brosseau L, Wells GA, Kenny GP, Reid R, Maetzel A, Tugwell P, Huijbregts M, McCullough C, de Angelis G, Chen L. The implementation of a community-based aerobic walking program for mild to moderate knee osteoarthritis (OA): a knowledge translation (KT) randomized controlled trial (RCT): part I: the uptake of the Ottawa Panel clinical practice guidelines (CPGs). BMC Public Health 2012 Oct 13;12(871):Epub 2012.
16.
Wang X, Youngstedt SD. Sleep quality improved following a single session of moderate-intensity aerobic exercise in older women: results from a pilot study. J Sport Health Sci. 2014;3(4):338–42.CrossRefPubMedPubMedCentral
17.
Esser S, Bailey A. Effects of exercise and physical activity on knee osteoarthritis. Curr Pain Headache R. 2011;15(6):423–30.CrossRef
18.
Fernandes L, Hagen KB, Bijlsma JWJ, Andreassen O, Christensen P, Conaghan PG, Doherty M, Geenen R, Hammond A, Kjeken I, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann Rheum Dis. 2013;72(7):1125–35.CrossRefPubMed
19.
Bower JE, Irwin MR. Mind–body therapies and control of inflammatory biology: a descriptive review. Brain Behav Immun. 2016;51:1–11.CrossRefPubMed
20.
Suokas AK, Walsh DA, McWilliams DF, Condon L, Moreton B, Wylde V, Arendt-Nielsen L, Zhang W. Quantitative sensory testing in painful osteoarthritis: a systematic review and meta-analysis. Osteoarthr Cartilage. 2012;20(10):1075–85.CrossRef
21.
Mills EJ, Thorlund K, Ioannidis JP. Demystifying trial networks and network meta-analysis. BMJ. 2013;346:f2914.CrossRefPubMed
22.
Higgins JPT, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JAC, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ (Clinical research ed). 2011;343:d5928.CrossRef
23.
Singh JA, Tugwell P, Zanoli G, Wells GA. Total joint replacement surgery for knee osteoarthritis and other non-traumatic diseases: a network meta-analysis. Cochrane Database Syst Rev. 2015;(6). Art. No.: CD011765. doi:10.​1002/​14651858.​CD011765.
24.
Pescatello LS, Arena R, Riebe D, Thompson P. ACSM’s guidelines for exercise testing and prescription. 9th ed. Baltimore: Lippincott Williams & Wilkins; 2013.
25.
26.
27.
Regnaux JP, Lefevre-Colau MM, Trinquart L, Nguyen C, Boutron I, Brosseau L, Ravaud P. High-intensity versus low-intensity physical activity or exercise in people with hip or knee osteoarthritis. Cochrane Database Syst Rev. 2015;(10). Art No.: CD010203. doi:10.​1002/​14651858.​CD010203.​pub2.
28.
Dobson F, Hinman R, Hall M, Terwee C, Roos EM, Bennell K. Measurement properties of performance-based measures to assess physical function in hip and knee osteoarthritis: a systematic review. Osteoarthr Cartilage. 2012;20(12):1548–62.CrossRef
29.
Higgins JPT, Green S (editors). Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated March 2011]. The Cochrane Collaboration. 2011. Available from www.​cochrane-handbook.​org.
30.
Tubach F, Ravaud P, Baron G, Falissard B, Logeart I, Bellamy N, et al. Evaluation of clinically relevant changes in patient reported outcomes in knee and hip osteoarthritis: the minimal clinically important improvement. Ann Rheum Dis. 2005;64(1):29–33.CrossRefPubMed
31.
van Middelkoop M, Dziedzic KS, Doherty M, Zhang W, Bijlsma JW, McAlindon TE, Lohmander SL, Bierma-Zeinstra SM. Individual patient data meta-analysis of trials investigating the effectiveness of intra-articular glucocorticoid injections in patients with knee or hip osteoarthritis: an OA trial bank protocol for a systematic review. Syst Rev. 2013;2(1):1–8.CrossRef
32.
Van Middelkoop M, Arden N, Atchia I, Birrell F, Chao J, Rezende M, Lambert R, Ravaud P, Bijlsma J, Doherty M. The OA trial bank: meta-analysis of individual patient data from knee and hip osteoarthritis trials show that patients with severe pain exhibit greater benefit from intra-articular glucocorticoids. Osteoarthr Cartilage. 2016;24:1143–52.CrossRef
33.
Royston P, Sauerbrei W. Interactions between treatment and continuous covariates: a step toward individualizing therapy. J Clin Oncol. 2008;26(9):1397–9.CrossRefPubMed
34.
Nüesch E, Trelle S, Reichenbach S, Rutjes AWS, Tschannen B, Altman DG, Egger M, Jüni P. Small study effects in meta-analyses of osteoarthritis trials: meta-epidemiological study. BMJ. 2010;341:c3515.CrossRefPubMedPubMedCentral
Metadata
Title
Relative efficacy of different types of exercise for treatment of knee and hip osteoarthritis: protocol for network meta-analysis of randomised controlled trials
Authors
Siew-Li Goh
Monica S. M. Persson
Archan Bhattacharya
Michelle Hall
Michael Doherty
Weiya Zhang
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2016
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-016-0321-6

Other articles of this Issue 1/2016

Systematic Reviews 1/2016 Go to the issue

Research

Insertion torque recordings for the diagnosis of contact between orthodontic mini-implants and dental roots: a systematic review

Research

Previously unidentified duplicate registrations of clinical trials: an exploratory analysis of registry data worldwide

Protocol

Brazilian oral herbal medication for osteoarthritis: a systematic review protocol

Protocol

Economic evidence for the prevention and treatment of atopic eczema: a protocol for a systematic review

Protocol

Incidence, causes, and consequences of preventable adverse drug events: protocol for an overview of reviews

Protocol

Health service provider education and/or training in infant male circumcision to improve short- and long-term morbidity outcomes: protocol for systematic review