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BMJ Review: Aerobic Exercise Works Best for Knee Osteoarthritis

The analysis backs walking, cycling, or swimming based on moderate-certainty gains in pain relief with better function.

Overview

  • A comprehensive BMJ review of 217 randomized trials with 15,684 participants found walking, cycling, and swimming delivered the strongest relief for knee osteoarthritis.
  • Moderate-certainty evidence showed aerobic exercise reduced pain in the short and mid term and improved physical function at every follow-up point.
  • Researchers evaluated pain, function, gait, and quality of life at 4, 12, and 24 weeks using a recognized grading framework for evidence quality.
  • No exercise type increased adverse events compared with controls, indicating that structured exercise is a safe treatment option.
  • Other modalities such as strengthening, mind-body, and neuromotor training provided targeted gains, but the authors recommend them as complements to aerobic activity rather than replacements.