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Osteoarthritis

Small but relevant effects of exercise therapy in osteoarthritis

Evidence for the effectiveness of exercise in osteoarthritis, particularly the long-term benefit, remains unclear. Now, a review of current evidence suggests that the benefits could be negligible. This finding raises an important question: should exercise therapy continue to be recommended as a first-line treatment for osteoarthritis?

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References

  1. Schleimer, T. et al. Effectiveness of exercise therapy for osteoarthritis: an overview of systematic reviews and randomised controlled trials. RMD Open 12, e006275 (2026).

    Article  PubMed  PubMed Central  Google Scholar 

  2. Zhang, W., Robertson, J., Jones, A. C., Dieppe, P. A. & Doherty, M. The placebo effect and its determinants in osteoarthritis: meta-analysis of randomised controlled trials. Ann. Rheum. Dis. 67, 1716–1723 (2008).

    Article  CAS  PubMed  Google Scholar 

  3. Balsby, I. M. et al. Comparative effectiveness of different placebos and comparator groups for hand osteoarthritis exploring the impact of contextual factors: A systematic review and meta-analysis of randomised trials. Osteoarthritis Cartilage 32, 848–857 (2024).

    Article  PubMed  Google Scholar 

  4. Pisters, M. F., Veenhof, C., van Dijk, G. M., Dekker, J. & CARPA Study Group. Avoidance of activity and limitations in activities in patients with osteoarthritis of the hip or knee: a 5 year follow-up study on the mediating role of reduced muscle strength. Osteoarthritis Cartilage 22, 171–177 (2014).

    Article  CAS  PubMed  Google Scholar 

  5. Scott, D. L. et al. The long-term effects of non-steroidal anti-inflammatory drugs in osteoarthritis of the knee: a randomized placebo-controlled trial. Rheumatology 39, 1095–1101 (2000).

    Article  CAS  PubMed  Google Scholar 

  6. Segal, N. A. & Glass, N. A. Is quadriceps muscle weakness a risk factor for incident or progressive knee osteoarthritis? Phys. Sportsmed. 39, 44–50 (2011).

    Article  PubMed  Google Scholar 

  7. van Middelkoop, M. et al. People with short symptom duration of knee osteoarthritis benefit more from exercise therapy than people with longer symptom duration: An individual participant data meta-analysis from the OA trial bank. Osteoarthritis Cartilage 32, 1620–1627 (2024).

    Article  PubMed  Google Scholar 

  8. Holden, M. A. et al. Moderators of the effect of therapeutic exercise for knee and hip osteoarthritis: a systematic review and individual participant data meta-analysis. Lancet Rheumatol. 5, e386–e400 (2023).

    Article  CAS  PubMed  Google Scholar 

  9. Runhaar, J., Luijsterburg, P., Dekker, J. & Bierma-Zeinstra, S. M. A. Identifying potential working mechanisms behind the positive effects of exercise therapy on pain and function in osteoarthritis; a systematic review. Osteoarthritis Cartilage 23, 1071–1082 (2015).

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Sita Bierma-Zeinstra.

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Bierma-Zeinstra, S., Runhaar, J. Small but relevant effects of exercise therapy in osteoarthritis. Nat Rev Rheumatol (2026). https://doi.org/10.1038/s41584-026-01377-3

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