A systematic review and network meta-analysis evaluated the efficacy and safety of different exercise modalities for managing knee osteoarthritis, including aerobic, flexibility, mind-body, neuromotor, strengthening, and mixed exercises. A total of 217 randomized controlled trials involving 15,684 participants were analyzed, with outcomes assessed at short-term (4 weeks), mid-term (12 weeks), and long-term (24 weeks) follow-up. Moderate-certainty evidence showed that aerobic exercise probably provides the greatest improvements in pain, function, gait performance, and quality of life compared with control, particularly at short and mid-term follow-up. Mind-body and neuromotor exercises improved function and gait performance at short term, while strengthening and mixed exercises enhanced function at mid-term. Flexibility, aerobic, and mixed exercises showed benefits for pain and function in the long term, though with lower certainty. Across all outcomes, aerobic exercise had the highest likelihood of being the most effective intervention, and safety profiles were similar among all exercise types. Overall, aerobic exercise appears to be the most beneficial and evidence-supported approach for improving key outcomes in patients with knee osteoarthritis. Source: https://www.bmj.com/
