Edorium Journal of

Disability and Rehabilitation

 
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Review Article
 
Effects of strength training, multimodal exercise and manual mobilization on pain and function in knee osteoarthritis: A systematic review and meta-analysis
Anna Frances Quillfeldt1, Rebecca Melissa Marks1
1BClinSc, MOstMed, School of Health and Human Sciences, Southern Cross University, Lismore, NSW, Australia.

Article ID: 100009D05AQ2016
doi:10.5348/D05-2016-9-RA-5

Address correspondence to:
Anna Frances Quillfeldt
C/O Julie Streckfuss, School of Health and Human Sciences
Southern Cross University
PO Box 157, Lismore, NSW
Australia, 2480

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How to cite this article
Quillfeldt AF, Marks RM. Effects of strength training, multimodal exercise and manual mobilization on pain and function in knee osteoarthritis: A systematic review and meta-analysis. Edorium J Disabil Rehabil 2016;2:34–42.


Abstract
Osteoarthritis is a major contributor to pain and disability, and while ample evidence suggests that exercise and manual therapy are beneficial for improving pain and function of sufferers, the body of research lacks evidence comparing the different intervention types. A systematic review with meta-analysis was performed to determine the effect of strength training, multi-modal exercise therapy and manual mobilization on pain and physical function in people with osteoarthritis of the knee. A search of MEDLINE, PEDro, and CINAHL was performed (January 2009 – May 2014). Trials incorporating either strength training alone, multi-modal exercise (strength training and active range of motion exercises with or without aerobic activity) or exercise plus additional manual mobilization were included. Meta-analyses were performed for each intervention type and both pain and physical function outcome measures. Results: Data from eight eligible studies was integrated. The search did not reveal trials comparing the effects of manual mobilization and exercise therefore this comparison could not be analyzed. Strength training demonstrated a larger effect size [pain = 1.26 (95% CI 0.97 to 1.55); physical function =1.15 (95% CI 0.87 to 1.44)] compared to multi-modal exercise [pain = 0.47 (95% CI 0.24 to 0.69); physical function = 0.53 (95% CI 0.30 to 0.75)]. In conclusion, Strength training and multi-modal exercise were both found to be effective in reducing pain and improving physical function in people with osteoarthritis of the knee. Strength training alone revealed more favorable effect sizes than multi-modal exercise.

Keywords: Arthritis, Exercise, Knee osteoarthritis, Manual therapy, Strength training


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Author Contributions:
Anna Frances Quillfeldt – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Rebecca Melissa Marks – Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 Anna Frances Quillfeldt et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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