- Resistance training is the foremost nonpharmacological intervention for pain relief in elderly patients with osteoarthritis (OA), according to a network meta-analysis.
- Yoga is the foremost intervention for elderly women in subgroup analysis.
Why this matters
- Nonpharmacological interventions vary greatly in efficacy and expense.
- Network meta-analysis of 32 randomized controlled trials (n=3228), after search of PubMed, OVID, EMBASE, Cochrane Library, PsycINFO, Physiotherapy Evidence Database, among others.
- Primary outcome was pain relief assessed by the Western Ontario and McMaster Universities Osteoarthritis Index, and other measures.
- Funding: None.
- The most effective nonpharmacological interventions were:
- Resistance training (surface under the cumulative ranking [SUCRA], 82.9%; standardized mean difference [SMD], 1.96; 95% CI, −1.39 to 5.31),
- Strengthening exercise (SUCRA, 74.1%; SMD, 1.21; 95% CI, −0.62 to 3.05), and
- Aquatic exercise (SUCRA, 65.3%; SMD, 0.75; 95% CI, −2.18 to 3.67).
- The least effective nonpharmacological interventions were:
- Weight loss (SUCRA, 17.8%; SMD, 3.77; 95% CI, −0.23 to 7.76),
- Healing touch (SUCRA, 35.1%; SMD, −0.63; 95% CI, −2.93 to 1.68), and
- Acupuncture (SUCRA, 37.8%; SMD, −0.43; 95% CI, −2.08 to 1.22).
- In subgroup analysis, the most effective interventions were:
- Yoga for women (SUCRA, 82.4%; SMD not reported).
- Strengthening exercise for greatest long-term benefit (SUCRA, 98.2%; SMD not reported).
- Small number of participants across trials.