Aerobic Exercise Identified as Most Effective Modality for Knee Osteoarthritis in Network Meta-Analysis

A systematic review and network meta-analysis comparing the effectiveness of different exercise interventions for knee osteoarthritis found that aerobic exercise may offer the greatest improvements in pain, function, gait performance, and quality of life. The analysis included data from a large number of randomized controlled trials and participants.

The review evaluated a range of exercise modalities, including aerobic, flexibility, mind-body, neuromotor, strengthening, and mixed exercise, against control interventions. Outcomes were assessed at short-term, mid-term, and long-term follow-up points. When studies did not report data at those exact time points, results from nearby intervals were used.

Moderate-certainty evidence indicated that aerobic exercise likely leads to meaningful reductions in pain and improvements in function, gait performance, and quality of life, particularly in the short and mid-term.

Other types of exercise also showed benefits. Mind-body exercise was associated with improved function in the short term, while neuromotor exercise was linked to better gait performance. Strengthening and mixed exercise were associated with gains in function over the mid-term.

At longer-term follow-up, flexibility exercise may reduce pain, while both aerobic and mixed exercise may improve function. Mixed exercise also appears to support better gait performance in the long run.

Across all measured outcomes, aerobic exercise consistently ranked as the most effective approach. Safety data were reported in a small subset of studies, with no meaningful differences in adverse events observed between exercise types and control groups.

The findings suggest that aerobic exercise is likely to be the most beneficial single intervention for improving key outcomes in people with knee osteoarthritis, based on currently available evidence.