Recent highlights and uncertainties in exercise management of knee osteoarthritis

This review highlighted six themes formulated as questions: Is exercise as effective as previously thought? How does exercise work and who might benefit the most? Is there an optimal exercise dose and type? Can patient adherence be improved - and does it matter? Do patients need to be seen in person to deliver exercise? How does communication about osteoarthritis influence patient beliefs about exercise? There were several key findings related to these themes. First, there was reduced certainty in the effectiveness of exercise for knee OA. Additionally, the mechanisms by which exercise improves clinical outcomes are largely unknown and it is unclear which individuals benefit the most from exercise. Research has failed to demonstrate a dose-response relationship between exercise and clinical outcomes and improving patient adherence to exercise may not lead to improved clinical outcomes. Nonetheless, exercise therapy can be effectively delivered remotely via a variety of methods. Communicating about OA using an impairment-based approach has been causally linked to negative beliefs about exercise.