Exercise for knee osteoarthritis pain : Association or causation?
Henriksen, Marius ; Runhaar, Jos ; Turkiewicz, Aleksandra LU and Englund, Martin LU
(2024)
In Osteoarthritis and Cartilage
- Abstract
Exercise is universally recommended as a primary strategy for the management of knee osteoarthritis (OA) pain. The recommendations are based on results from more than 100 randomized controlled trials (RCTs) that compare exercise to no-attention control groups. However, due to the inherent difficulties with adequate placebo control, participant blinding and the use of patient-reported outcomes, the existing RCT evidence is imperfect. To better understand the evidence used to support a causal relationship between exercise and knee OA pain relief, we examined the existing evidence through the Bradford Hill considerations for causation. The Bradford Hill considerations, first proposed in 1965 by Sir Austin Bradford Hill, provide a framework... (More)
Exercise is universally recommended as a primary strategy for the management of knee osteoarthritis (OA) pain. The recommendations are based on results from more than 100 randomized controlled trials (RCTs) that compare exercise to no-attention control groups. However, due to the inherent difficulties with adequate placebo control, participant blinding and the use of patient-reported outcomes, the existing RCT evidence is imperfect. To better understand the evidence used to support a causal relationship between exercise and knee OA pain relief, we examined the existing evidence through the Bradford Hill considerations for causation. The Bradford Hill considerations, first proposed in 1965 by Sir Austin Bradford Hill, provide a framework for assessment of possible causal relationships. There are 9 considerations by which the evidence is reviewed: Strength of association, Consistency, Specificity, Temporality, Biological Gradient (Dose-Response), Plausibility, Coherence, Experiment, and Analogy. Viewing the evidence from these 9 viewpoints did neither bring forward indisputable evidence for nor against the causal relationship between exercise and improved knee OA pain. Rather, we conclude that the current evidence is not sufficient to support claims about (lack of) causality. With our review, we hope to advance the continued global conversation about how to improve the evidence-based management of patients with knee OA.
(Less)
- author
- Henriksen, Marius
; Runhaar, Jos
; Turkiewicz, Aleksandra
LU
and Englund, Martin
LU
- organization
- publishing date
- 2024
- type
- Contribution to journal
- publication status
- epub
- subject
- keywords
- Association, Bradford Hill, Causality, Exercise, Knee, Osteoarthritis
- in
- Osteoarthritis and Cartilage
- publisher
- Elsevier
- external identifiers
-
- pmid:38490293
- scopus:85188513541
- ISSN
- 1063-4584
- DOI
- 10.1016/j.joca.2024.03.001
- language
- English
- LU publication?
- yes
- id
- fc009043-8cff-4ac3-baaa-95d89e31d69f
- date added to LUP
- 2024-04-15 13:32:46
- date last changed
- 2024-04-29 15:27:01
@article{fc009043-8cff-4ac3-baaa-95d89e31d69f,
abstract = {{<p>Exercise is universally recommended as a primary strategy for the management of knee osteoarthritis (OA) pain. The recommendations are based on results from more than 100 randomized controlled trials (RCTs) that compare exercise to no-attention control groups. However, due to the inherent difficulties with adequate placebo control, participant blinding and the use of patient-reported outcomes, the existing RCT evidence is imperfect. To better understand the evidence used to support a causal relationship between exercise and knee OA pain relief, we examined the existing evidence through the Bradford Hill considerations for causation. The Bradford Hill considerations, first proposed in 1965 by Sir Austin Bradford Hill, provide a framework for assessment of possible causal relationships. There are 9 considerations by which the evidence is reviewed: Strength of association, Consistency, Specificity, Temporality, Biological Gradient (Dose-Response), Plausibility, Coherence, Experiment, and Analogy. Viewing the evidence from these 9 viewpoints did neither bring forward indisputable evidence for nor against the causal relationship between exercise and improved knee OA pain. Rather, we conclude that the current evidence is not sufficient to support claims about (lack of) causality. With our review, we hope to advance the continued global conversation about how to improve the evidence-based management of patients with knee OA.</p>}},
author = {{Henriksen, Marius and Runhaar, Jos and Turkiewicz, Aleksandra and Englund, Martin}},
issn = {{1063-4584}},
keywords = {{Association; Bradford Hill; Causality; Exercise; Knee; Osteoarthritis}},
language = {{eng}},
publisher = {{Elsevier}},
series = {{Osteoarthritis and Cartilage}},
title = {{Exercise for knee osteoarthritis pain : Association or causation?}},
url = {{http://dx.doi.org/10.1016/j.joca.2024.03.001}},
doi = {{10.1016/j.joca.2024.03.001}},
year = {{2024}},
}