TY - JOUR
T1 - Evidence for key individual characteristics associated with outcomes following combined first-line interventions for knee osteoarthritis
T2 - A systematic review
AU - Couldrick, Jacqui M.
AU - Woodward, Andrew P.
AU - Silva, M. C.Denika
AU - Lynch, Joseph T.
AU - Perriman, Diana M.
AU - Barton, Christian J.
AU - Scarvell, Jennie M.
N1 - Funding Information:
We would like to acknowledge the help of Murray Turner, a Health Information Specialist at the University of Canberra, in assisting JC with the search strategy design.
Publisher Copyright:
© 2023 Couldrick et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2023/4
Y1 - 2023/4
N2 - Objective To identify individual characteristics associated with outcomes following combined first-line interventions for knee osteoarthritis. Methods MEDLINE, CINAHL, Scopus, Web of Science Core Collection and the Cochrane library were searched. Studies were included if they reported an association between baseline factors and change in pain or function following combined exercise therapy, osteoarthritis education, or weight management interventions for knee osteoarthritis. Risk of bias was assessed using Quality in Prognostic Factor Studies. Data was visualised and a narrative synthesis was conducted for key factors (age, sex, BMI, comorbidity, depression, and imaging severity). Results 32 studies were included. Being female compared to male was associated with 2–3 times the odds of a positive response. Older age was associated with reduced odds of a positive response. The effect size (less than 10% reduction) is unlikely to be clinically relevant. It was difficult to conclude whether BMI, comorbidity, depression and imaging severity were associated with pain and function outcomes following a combined first-line intervention for knee osteoarthritis. Low to very low certainty evidence was found for sex, BMI, depression, comorbidity and imaging severity and moderate certainty evidence for age. Varying study methods contributed to some difficulty in drawing clear conclusions. Conclusions This systematic review found no clear evidence to suggest factors such as age, sex, BMI, OA severity and presence of depression or comorbidities are associated with the response to first-line interventions for knee OA. Current evidence indicates that some groups of people may respond equally to first-line interventions, such as those with or without comorbidities. First-line interventions consisting of exercise therapy, education, and weight loss for people with knee OA should be recommended irrespective of sex, age, obesity, comorbidity, depression and imaging findings.
AB - Objective To identify individual characteristics associated with outcomes following combined first-line interventions for knee osteoarthritis. Methods MEDLINE, CINAHL, Scopus, Web of Science Core Collection and the Cochrane library were searched. Studies were included if they reported an association between baseline factors and change in pain or function following combined exercise therapy, osteoarthritis education, or weight management interventions for knee osteoarthritis. Risk of bias was assessed using Quality in Prognostic Factor Studies. Data was visualised and a narrative synthesis was conducted for key factors (age, sex, BMI, comorbidity, depression, and imaging severity). Results 32 studies were included. Being female compared to male was associated with 2–3 times the odds of a positive response. Older age was associated with reduced odds of a positive response. The effect size (less than 10% reduction) is unlikely to be clinically relevant. It was difficult to conclude whether BMI, comorbidity, depression and imaging severity were associated with pain and function outcomes following a combined first-line intervention for knee osteoarthritis. Low to very low certainty evidence was found for sex, BMI, depression, comorbidity and imaging severity and moderate certainty evidence for age. Varying study methods contributed to some difficulty in drawing clear conclusions. Conclusions This systematic review found no clear evidence to suggest factors such as age, sex, BMI, OA severity and presence of depression or comorbidities are associated with the response to first-line interventions for knee OA. Current evidence indicates that some groups of people may respond equally to first-line interventions, such as those with or without comorbidities. First-line interventions consisting of exercise therapy, education, and weight loss for people with knee OA should be recommended irrespective of sex, age, obesity, comorbidity, depression and imaging findings.
UR - http://www.scopus.com/inward/record.url?scp=85152244826&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0284249
DO - 10.1371/journal.pone.0284249
M3 - Article
C2 - 37040393
AN - SCOPUS:85152244826
SN - 1932-6203
VL - 18
SP - 1
EP - 31
JO - PLoS One
JF - PLoS One
IS - 4 April
M1 - e0284249
ER -
