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Does Higher Compliance With American College of Sports Medicine Exercise Prescription Guidelines Influence Exercise Outcomes in Knee Osteoarthritis? A Systematic Review With Meta-Analysis

Lawford, Belinda J. LU ; Hinman, Rana S. ; Spiers, Libby ; Kimp, Alexander J. ; Dell'Isola, Andrea LU ; Harmer, Alison R. ; Van der Esch, Martin ; Hall, Michelle and Bennell, Kim L. (2024) In Arthritis Care and Research
Abstract

Objective: We wanted to determine if higher compliance with American College of Sports Medicine (ACSM) exercise prescription guidelines influences exercise outcomes in knee osteoarthritis (OA). Methods: We conducted a systematic review. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase up to January 4, 2024, for randomized controlled trials evaluating resistance and/or aerobic exercise for knee OA. Interventions were classified as higher compliance (meeting ≥60% of ACSM guideline recommendations for frequency, intensity, and duration) or lower compliance (meeting <60% of recommendations). Effects on pain and function were evaluated via meta-analysis, stratified by compliance. Results: Twenty-five... (More)

Objective: We wanted to determine if higher compliance with American College of Sports Medicine (ACSM) exercise prescription guidelines influences exercise outcomes in knee osteoarthritis (OA). Methods: We conducted a systematic review. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase up to January 4, 2024, for randomized controlled trials evaluating resistance and/or aerobic exercise for knee OA. Interventions were classified as higher compliance (meeting ≥60% of ACSM guideline recommendations for frequency, intensity, and duration) or lower compliance (meeting <60% of recommendations). Effects on pain and function were evaluated via meta-analysis, stratified by compliance. Results: Twenty-five trials (3,290 participants) evaluated combined resistance and aerobic programs, with no differences in outcomes between those with higher and lower compliance (standardized mean difference [SMD] pain: −0.38 [95% confidence interval (CI) −0.59 to −0.17] vs −0.31 [95% CI −0.45 to −0.16], respectively; SMD function: −0.43 [95% CI −0.64 to −0.21] vs −0.36 [95% CI −0.58 to −0.14]). Sixty-six trials (5,231 participants) evaluated resistance exercise, with no differences between interventions with higher and lower compliance (SMD pain: −0.60 [95% CI −0.81 to −0.39] vs −0.93 [95% CI −1.27 to −0.59]; SMD function: −0.64 [95% CI −0.83 to −0.44] vs −0.85 [95% CI −1.20 to −0.49]). Twelve trials (958 participants) evaluated aerobic exercise, with no differences between interventions with higher and lower compliance (SMD pain: −0.79 [95% CI −1.20 to −0.38] vs −1.00 [95% CI −2.52 to 0.53]; SMD function: −0.83 [95% CI −1.27 to −0.38] vs −0.76 [95% CI −2.02 to 0.50]). Conclusion: Higher or lower compliance with ACSM exercise prescription guidelines did not influence exercise outcomes. Given there was substantial heterogeneity and many publications were at risk of bias, our results should be interpreted with caution.

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organization
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Contribution to journal
publication status
epub
subject
in
Arthritis Care and Research
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:39400971
  • scopus:85208991133
ISSN
2151-464X
DOI
10.1002/acr.25451
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2024 American College of Rheumatology.
id
bb9253f9-8d9a-4a9a-8c6f-d045806fdf58
date added to LUP
2024-12-12 11:49:08
date last changed
2025-07-11 04:57:17
@article{bb9253f9-8d9a-4a9a-8c6f-d045806fdf58,
  abstract     = {{<p>Objective: We wanted to determine if higher compliance with American College of Sports Medicine (ACSM) exercise prescription guidelines influences exercise outcomes in knee osteoarthritis (OA). Methods: We conducted a systematic review. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase up to January 4, 2024, for randomized controlled trials evaluating resistance and/or aerobic exercise for knee OA. Interventions were classified as higher compliance (meeting ≥60% of ACSM guideline recommendations for frequency, intensity, and duration) or lower compliance (meeting &lt;60% of recommendations). Effects on pain and function were evaluated via meta-analysis, stratified by compliance. Results: Twenty-five trials (3,290 participants) evaluated combined resistance and aerobic programs, with no differences in outcomes between those with higher and lower compliance (standardized mean difference [SMD] pain: −0.38 [95% confidence interval (CI) −0.59 to −0.17] vs −0.31 [95% CI −0.45 to −0.16], respectively; SMD function: −0.43 [95% CI −0.64 to −0.21] vs −0.36 [95% CI −0.58 to −0.14]). Sixty-six trials (5,231 participants) evaluated resistance exercise, with no differences between interventions with higher and lower compliance (SMD pain: −0.60 [95% CI −0.81 to −0.39] vs −0.93 [95% CI −1.27 to −0.59]; SMD function: −0.64 [95% CI −0.83 to −0.44] vs −0.85 [95% CI −1.20 to −0.49]). Twelve trials (958 participants) evaluated aerobic exercise, with no differences between interventions with higher and lower compliance (SMD pain: −0.79 [95% CI −1.20 to −0.38] vs −1.00 [95% CI −2.52 to 0.53]; SMD function: −0.83 [95% CI −1.27 to −0.38] vs −0.76 [95% CI −2.02 to 0.50]). Conclusion: Higher or lower compliance with ACSM exercise prescription guidelines did not influence exercise outcomes. Given there was substantial heterogeneity and many publications were at risk of bias, our results should be interpreted with caution.</p>}},
  author       = {{Lawford, Belinda J. and Hinman, Rana S. and Spiers, Libby and Kimp, Alexander J. and Dell'Isola, Andrea and Harmer, Alison R. and Van der Esch, Martin and Hall, Michelle and Bennell, Kim L.}},
  issn         = {{2151-464X}},
  language     = {{eng}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Arthritis Care and Research}},
  title        = {{Does Higher Compliance With American College of Sports Medicine Exercise Prescription Guidelines Influence Exercise Outcomes in Knee Osteoarthritis? A Systematic Review With Meta-Analysis}},
  url          = {{http://dx.doi.org/10.1002/acr.25451}},
  doi          = {{10.1002/acr.25451}},
  year         = {{2024}},
}