What is the evidence for proprioceptive exercise in the treatment of osteoarthritis of the knee?
AMSTAR Rating
Summary
Patient Population:
N=560 (357 female). Mean age = 63 years (±1.8). All but one study excluded individuals with extreme degenerative changes. (mostly K-L grade II or III).
Intervention:
All interventions were weight bearing, and based on functional activities (stepping, standing, walking and balancing). Exercise programs were conducted for 4-8 weeks.
Comparison:
7 studies compared the use of proprioceptive exercise to non-proprioceptive exercise. 3 studies included a comparison to a no-treatment control group. There were 7 studies selected for inclusion in the review – all were RCTs. Total PEDro scores ranged from 7-9. The greatest limitation noted by the authors was small sample size of the primary studies – all but three cohorts were underpowered and not informed by a sample size calculation. In addition, few studies reported between group differences.
Outcome:
- Function: proprioceptive exercise vs. no treatment – significant difference in favour of exercise at 8 weeks (MD=-12.19; 95% CI-15.67 to -8.71).
- Pain: proprioceptive exercise vs. no treatment – significant difference in favour of exercise at 8 weeks (p<0.01).
- Proprioceptive exercise vs. strengthening exercise: No significant difference in function.
- Proprioceptive exercise vs. general exercise: No significant difference in function or pain.
Guideline Recommendations
| Source | Recommendation |
|---|---|
| ACR (2019) | Conditionally recommended |
Outcomes Assessed
- Benefit
- Harm
- Inconclusive
Proprioceptive Exercise vs. No Treatment
Function
Pain
Proprioceptive vs. Strengthening Exercise
Function
Proprioceptive vs. General Exercise
Function
Pain
