Archives of physical medicine and rehabilitation · 2026
Efficacy of Progressive Exercise Snacking for Middle-Aged and Older Adults With Knee Osteoarthritis: A Systematic Review and Meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Meng Lidian, Chen Jiayi, Huo Xinxin, Zhang Yating, Zheng He
Аннотация
OBJECTIVE: To evaluate the effects of progressive exercise snacking (PES) in middle-aged and older adults with knee osteoarthritis (KOA) using meta-analysis.
DATA SOURCES: PubMed, Web of Science, CINAHL, Cochrane Library, and Scopus were searched from inception to October 5, 2025, with additional reference-list screening.
STUDY SELECTION: Randomized controlled trials (RCTs) assessing PES for KOA were included. Two reviewers independently screened studies using predefined criteria.
DATA EXTRACTION: Data on study characteristics, intervention protocols, outcomes, and adverse events were extracted. Outcomes included pain, joint function, gait performance, and quality of life at 4, 12, and 24 weeks postintervention.
DATA SYNTHESIS: Eighteen RCTs (n=1200) were included. PES improved pain at short-term follow-up (standardized mean difference [SMD]=-1.09; 95% confidence interval [CI]=-1.51 to -0.68; moderate certainty) and enhanced joint function (SMD=1.31; 95% CI=0.98-1.64; moderate certainty) and quality of life (SMD=0.97; 95% CI=0.14-1.79; low certainty). At midterm follow-up, PES improved gait performance (SMD=0.62; 95% CI=0.25-0.98; low certainty). Meta-regression suggested that benefits for pain, joint function, and gait performance diminished with longer follow-up. Subgroup analyses suggested that larger effects may be associated with shorter intervention duration (≤12 wk), higher weekly exercise dose (≥300 metabolic equivalent·min/wk), and walking as the primary modality. PES did not appear to increase adverse events (risk ratio=1.80; 95% CI=0.41-2.54; P>.05).
CONCLUSIONS: PES may provide short-term improvements in pain, joint function, and quality of life, and midterm improvements in gait performance in KOA, but long-term efficacy remains uncertain. Larger, high-quality RCTs with longer follow-up and standardized protocols are needed to confirm long-term effectiveness and safety.
DATA SOURCES: PubMed, Web of Science, CINAHL, Cochrane Library, and Scopus were searched from inception to October 5, 2025, with additional reference-list screening.
STUDY SELECTION: Randomized controlled trials (RCTs) assessing PES for KOA were included. Two reviewers independently screened studies using predefined criteria.
DATA EXTRACTION: Data on study characteristics, intervention protocols, outcomes, and adverse events were extracted. Outcomes included pain, joint function, gait performance, and quality of life at 4, 12, and 24 weeks postintervention.
DATA SYNTHESIS: Eighteen RCTs (n=1200) were included. PES improved pain at short-term follow-up (standardized mean difference [SMD]=-1.09; 95% confidence interval [CI]=-1.51 to -0.68; moderate certainty) and enhanced joint function (SMD=1.31; 95% CI=0.98-1.64; moderate certainty) and quality of life (SMD=0.97; 95% CI=0.14-1.79; low certainty). At midterm follow-up, PES improved gait performance (SMD=0.62; 95% CI=0.25-0.98; low certainty). Meta-regression suggested that benefits for pain, joint function, and gait performance diminished with longer follow-up. Subgroup analyses suggested that larger effects may be associated with shorter intervention duration (≤12 wk), higher weekly exercise dose (≥300 metabolic equivalent·min/wk), and walking as the primary modality. PES did not appear to increase adverse events (risk ratio=1.80; 95% CI=0.41-2.54; P>.05).
CONCLUSIONS: PES may provide short-term improvements in pain, joint function, and quality of life, and midterm improvements in gait performance in KOA, but long-term efficacy remains uncertain. Larger, high-quality RCTs with longer follow-up and standardized protocols are needed to confirm long-term effectiveness and safety.