Foster, NE ORCID: 0000-0003-4429-9756, Thomas, M and Holden, MA (2015) Is long term physical activity safe for older adults with knee pain: a systematic review. Osteoarthritis and Cartilage, 23 (9). pp. 1445-1456. ISSN 1522-9653

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Abstract

Objective
To determine whether long-term physical activity is safe for older adults with knee pain.

Design
A comprehensive systematic review and narrative synthesis of existing literature was conducted using multiple electronic databases from inception until May 2013. Two reviewers independently screened, checked data extraction and carried out quality assessment.

Inclusion criteria for study designs were randomised controlled trials (RCTs), prospective cohort studies or case control studies, which included adults of mean age over 45 years old with knee pain or osteoarthritis (OA), undertaking physical activity over at least 3 months and which measured a safety related outcome (adverse events, pain, physical functioning, structural OA imaging progression or progression to total knee replacement (TKR)).

Results
Of the 8614 unique references identified, 49 studies were included in the review, comprising 48 RCTs and one case control study. RCTs varied in quality and included an array of low impact therapeutic exercise interventions of varying cardiovascular intensity. There was no evidence of serious adverse events, increases in pain, decreases in physical function, progression of structural OA on imaging or increased TKR at group level. The case control study concluded that increasing levels of regular physical activity was associated with lower risk of progression to TKR.

Conclusions
Long-term therapeutic exercise lasting 3 to 30 months is safe for most older adults with knee pain. This evidence supports current clinical guideline recommendations. However, most studies investigated selected, consenting older adults carrying out low impact therapeutic exercise which may affect result generalizability.

Item Type: Article
Additional Information: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via Elsevier at https://doi.org/10.1016/j.joca.2015.05.002 Please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: OsteoarthritisKnee painSafetyPhysical activityExerciseSystematic review
Subjects: R Medicine > RA Public aspects of medicine
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Depositing User: Symplectic
Date Deposited: 21 May 2015 11:56
Last Modified: 25 Jun 2018 11:02
URI: http://eprints.keele.ac.uk/id/eprint/536

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