A review of the clinical evidence for exercise in osteoarthritis of the hip and knee
Abstract
Osteoarthritis (OA) is a chronic joint disease with the hip and knee being commonly affected lower limb sites. Osteoarthritis causes pain, stiffness, swelling, joint instability and muscle weakness, all of which can lead to impaired physical function and reduced quality of life. This review of evidence provides recommendations for exercise prescription in those with hip or knee OA. A narrative review was performed. Conservative non-pharmacological strategies, particularly exercise, are recommended by all clinical guidelines for the management of OA and meta-analyses support these exercise recommendations. Aerobic, strengthening, aquatic and Tai chi exercise are beneficial for improving pain and function in people with OA with benefits seen across the range of disease severities. The optimal exercise dosage is yet to be determined and an individualized approach to exercise prescription is required based on an assessment of impairments, patient preference, co-morbidities and accessibility. Maximising adherence is a key element dictating success of exercise therapy. This can be enhanced by the use of supervised exercise sessions (possibly in class format) in the initial exercise period followed by home exercises. Bringing patients back for intermittent consultations with the exercise practitioner, or attendance at "refresher" group exercise classes may also assist long-term adherence and improved patient outcomes. Few studies have evaluated the effects of exercise on structural disease progression and there is currently no evidence to show that exercise can be disease modifying. Exercise plays an important role in managing symptoms in those with hip and knee OA.
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Exercise, including aerobic, strengthening and aquatic exercise, reduces pain and improves physical function and quality of life in chronic pain.
“Exercise, including aerobic, strengthening and aquatic exercise has been shown to reduce pain and improve physical function and quality of life [15–17]”
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- Authors
- Bennell, K. L., & Hinman, R. S.
- Affiliations
- The University of Melbourne (AU)
- Venue
- Journal of Science and Medicine in Sport
- Publisher
- Elsevier BV
- Published
- 2011-01
- Volume
- 14
- Issue
- 1
- Pages
- 4-9
- ISSN
- 1440-2440 (ISSN-L)
- OpenAlex
- W2156856211
- Cited by
- 492
- References
- 47
- Citations by year
- 2026: 14 · 2025: 21 · 2024: 38 · 2023: 25 · 2022: 29 · 2021: 42 · 2020: 34 · 2019: 34 · 2018: 40 · 2017: 39 · 2016: 39 · 2015: 32 · 2014: 33 · 2013: 36 · 2012: 23
- FWCI
- 3.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of science and medicine in sport (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- osteoarthritis, hip osteoarthritis, knee osteoarthritis, exercise therapy, exercise prescription, aerobic exercise, resistance training, aquatic exercise, Tai Chi, exercise adherence, supervised exercise, home-based exercise, pain, physical function, disease progression, non-pharmacological treatment
- MeSH terms
- Exercise Therapy, Humans, Obesity, Patient Compliance, Osteoarthritis, Hip, Exercise, Treatment Outcome, Osteoarthritis, Knee, Tai Ji, Resistance Training
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