Effect of aerobic exercise on cardiopulmonary fitness among people with knee osteoarthritis: a systematic review and meta-analysis
Abstract Background Although aerobic exercise is widely recommended to enhance cardiopulmonary fitness and mitigate cardiovascular risk, the efficacy and effectiveness of aerobic exercise interventions have not been comprehensively evaluated among people with knee osteoarthritis (OA). This systemati...
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BMC
2025-06-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-025-08746-1 |
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| author | Shan Su Clare Chung-Wah Yu Emma Feng-Ming Zhou Jing-Yuan Liu Siu-Ngor Fu |
| author_facet | Shan Su Clare Chung-Wah Yu Emma Feng-Ming Zhou Jing-Yuan Liu Siu-Ngor Fu |
| author_sort | Shan Su |
| collection | DOAJ |
| description | Abstract Background Although aerobic exercise is widely recommended to enhance cardiopulmonary fitness and mitigate cardiovascular risk, the efficacy and effectiveness of aerobic exercise interventions have not been comprehensively evaluated among people with knee osteoarthritis (OA). This systematic review and meta-analysis aimed to synthesize the current evidence on the impact of aerobic exercise on cardiopulmonary fitness in people with knee OA. Methods PubMed, Embase, Scopus, and Web of Science were searched from inception to March 1, 2024, for randomized controlled trials (RCTs). Eligible RCTs included those with an aerobic exercise intervention (e.g., aerobic walking, cycling, aquatic aerobics), a primary outcome of maximum oxygen consumption (VO2 max), and participants with knee OA. The aerobic exercise programs were compared to control interventions (e.g., education, light-intensity exercise, usual activities, and routine care). Secondary outcomes included distance (m) walked during the six-minute walk test (6MWD), and Patient-Reported Outcome Measures (i.e., pain score and disability score). The overall level of evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results Out of 988 studies, 5 RCTs with 459 people with knee OA were included in the analysis. Aerobic exercise programs included walking, cycling, jumping, stepping, and aquatic aerobics. Pooled mean differences and 95% confidence intervals (CIs) were 0.90 ml/kg/min (95% CI 0.43 to 1.38; moderate evidence), 46.97 m (95% CI 33.71 to 60.23; high evidence), 5.59 points (95% CI 2.93 to 8.25; low evidence), and 3.03 points (95% CI 1.05 to 5.01; moderate evidence) for VO2 max, 6MWD, pain and disability, respectively. Conclusion These results support the hypothesis that aerobic exercise can elicit improvements in cardiopulmonary fitness for people with knee OA. Future research should focus on optimizing current exercise regimens for people with knee OA and exploring how to improve adherence while minimizing symptom exacerbation by other exercise modalities, e.g., Nordic walking and inspiratory muscle training. Systematic review registration CRD42022340966, 07/07/2022, PROSPERO. |
| format | Article |
| id | doaj-art-799648069a5444938c86eb8717256107 |
| institution | DOAJ |
| issn | 1471-2474 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj-art-799648069a5444938c86eb87172561072025-08-20T03:10:28ZengBMCBMC Musculoskeletal Disorders1471-24742025-06-0126111210.1186/s12891-025-08746-1Effect of aerobic exercise on cardiopulmonary fitness among people with knee osteoarthritis: a systematic review and meta-analysisShan Su0Clare Chung-Wah Yu1Emma Feng-Ming Zhou2Jing-Yuan Liu3Siu-Ngor Fu4Department of Rehabilitation Sciences, The Hong Kong Polytechnic UniversityDepartment of Rehabilitation Sciences, The Hong Kong Polytechnic UniversityDepartment of Rehabilitation Sciences, The Hong Kong Polytechnic UniversityDepartment of Applied Social Sciences, The Hong Kong Polytechnic UniversityDepartment of Rehabilitation Sciences, The Hong Kong Polytechnic UniversityAbstract Background Although aerobic exercise is widely recommended to enhance cardiopulmonary fitness and mitigate cardiovascular risk, the efficacy and effectiveness of aerobic exercise interventions have not been comprehensively evaluated among people with knee osteoarthritis (OA). This systematic review and meta-analysis aimed to synthesize the current evidence on the impact of aerobic exercise on cardiopulmonary fitness in people with knee OA. Methods PubMed, Embase, Scopus, and Web of Science were searched from inception to March 1, 2024, for randomized controlled trials (RCTs). Eligible RCTs included those with an aerobic exercise intervention (e.g., aerobic walking, cycling, aquatic aerobics), a primary outcome of maximum oxygen consumption (VO2 max), and participants with knee OA. The aerobic exercise programs were compared to control interventions (e.g., education, light-intensity exercise, usual activities, and routine care). Secondary outcomes included distance (m) walked during the six-minute walk test (6MWD), and Patient-Reported Outcome Measures (i.e., pain score and disability score). The overall level of evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results Out of 988 studies, 5 RCTs with 459 people with knee OA were included in the analysis. Aerobic exercise programs included walking, cycling, jumping, stepping, and aquatic aerobics. Pooled mean differences and 95% confidence intervals (CIs) were 0.90 ml/kg/min (95% CI 0.43 to 1.38; moderate evidence), 46.97 m (95% CI 33.71 to 60.23; high evidence), 5.59 points (95% CI 2.93 to 8.25; low evidence), and 3.03 points (95% CI 1.05 to 5.01; moderate evidence) for VO2 max, 6MWD, pain and disability, respectively. Conclusion These results support the hypothesis that aerobic exercise can elicit improvements in cardiopulmonary fitness for people with knee OA. Future research should focus on optimizing current exercise regimens for people with knee OA and exploring how to improve adherence while minimizing symptom exacerbation by other exercise modalities, e.g., Nordic walking and inspiratory muscle training. Systematic review registration CRD42022340966, 07/07/2022, PROSPERO.https://doi.org/10.1186/s12891-025-08746-1Knee osteoarthritisAerobic exerciseCardiopulmonary fitness |
| spellingShingle | Shan Su Clare Chung-Wah Yu Emma Feng-Ming Zhou Jing-Yuan Liu Siu-Ngor Fu Effect of aerobic exercise on cardiopulmonary fitness among people with knee osteoarthritis: a systematic review and meta-analysis BMC Musculoskeletal Disorders Knee osteoarthritis Aerobic exercise Cardiopulmonary fitness |
| title | Effect of aerobic exercise on cardiopulmonary fitness among people with knee osteoarthritis: a systematic review and meta-analysis |
| title_full | Effect of aerobic exercise on cardiopulmonary fitness among people with knee osteoarthritis: a systematic review and meta-analysis |
| title_fullStr | Effect of aerobic exercise on cardiopulmonary fitness among people with knee osteoarthritis: a systematic review and meta-analysis |
| title_full_unstemmed | Effect of aerobic exercise on cardiopulmonary fitness among people with knee osteoarthritis: a systematic review and meta-analysis |
| title_short | Effect of aerobic exercise on cardiopulmonary fitness among people with knee osteoarthritis: a systematic review and meta-analysis |
| title_sort | effect of aerobic exercise on cardiopulmonary fitness among people with knee osteoarthritis a systematic review and meta analysis |
| topic | Knee osteoarthritis Aerobic exercise Cardiopulmonary fitness |
| url | https://doi.org/10.1186/s12891-025-08746-1 |
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