Scientists have been trying to understand why some exercises help people with knee pain more than others, especially as osteoarthritis becomes one of the most common reasons adults struggle with mobility. The condition, that stems from the gradual breakdown of cartilage at the ends of bones, eventually causes swelling, stiffness, and persistent discomfort. While it can affect any joint, knee osteoarthritis is particularly widespread, studies show that nearly 30% of adults over 45 display signs of it on x-rays, and almost half of them go on to face daily pain or movement challenges.What has remained unclear is which type of exercise offers the most reliable relief. Although movement is considered essential in osteoarthritis care, treatment guidelines often stop short of naming one approach as the most effective. To resolve that gap, researchers conducted an extensive analysis comparing different forms of exercise used by people with knee osteoarthritis.
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Their findings, published in The BMJ, point strongly toward aerobic activity. After reviewing 217 randomized clinical trials conducted between 1990 and 2024, involving 15,684 participants, the researchers concluded that exercises such as walking, cycling, and swimming consistently outperformed other methods in easing pain, improving function, and enhancing overall quality of life. They compared aerobic routines with flexibility training, strengthening work, mind-body exercises, neuromotor programs, and mixed approaches, using control groups as a baseline.The team evaluated outcomes through the internationally recognized GRADE system, examining pain reduction, physical function, gait performance, and quality of life at four-week, 12-week, and 24-week intervals. Across nearly every measure and timeframe, aerobic exercise ranked at the top.Moderate-certainty evidence showed that aerobic activity reduced short, and mid-term pain, improved physical function in the short and long term, and boosted both gait performance and quality of life in the early and mid stages. Other exercise styles had their strengths, mind-body workouts appeared to support short-term function, neuromotor exercises improved short-term gait, and strengthening or mixed routines offered mid-term functional gains, but none matched the broader and more consistent benefits of aerobic movement.Safety was also a priority in the analysis, and the researchers noted that none of the exercise categories caused more adverse events than the control groups. At the same time, they acknowledged limitations such as reliance on indirect comparisons, limited long-term data for certain outcomes, and the influence smaller studies may have had on early findings.According to the authors, aerobic activity should be used “as a first line intervention for knee osteoarthritis management, particularly when the aim is to improve functional capacity and reduce pain.” They add that if aerobic exercise is not feasible because of individual limitations, “alternative forms of structured physical activity may still be beneficial.”Note: The information provided in this article is for educational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional before starting any new medication or treatment and before changing your diet or supplement regimen.