Efficacy of non-pharmacological interventions for knee osteoarthritis in the elderly: A systematic review and meta-analysis

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background Knee osteoarthritis (KOA) is highly prevalent in the elderly. Non-pharmacological treatments are recommended as first-line management, but high-quality evidence synthesis is lacking. Methods We conducted a systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Databases were searched from January 2002 to July 2025. Two reviewers independently screened literature, extracted data, and assessed risk of bias using Cochrane Risk of Bias 2.0. Meta-analysis was performed using a random-effects model. Results A total of 13 randomized controlled trials were included in this meta-analysis. Exercise therapy significantly relieved pain and improved physical function in elderly patients with KOA (standardized mean difference [SMD] = -0.66, 95% confidence interval (CI): -1.25 to -0.06, I2 = 80%) (after sensitivity analysis). TCM non-pharmacological therapies also yielded significant beneficial effects (SMD = -0.21, 95% CI: -0.54 to 0.12, I2 = 72%), whereas physical therapy modalities showed no statistically significant difference (SMD = -0.16, 95% CI: -0.43 to 0.10, I2 = 65%). High heterogeneity was mainly attributed to diverse outcome measurement scales and intervention intensity, duration, and protocols. Conclusion Non-pharmacological interventions effectively relieve pain and improve function in elderly

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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