The aim of this systematic review and network meta-analysis (NMA) was to evaluate the relative efficacy of four most popular MBE modes (Pilates, Tai Chi (TC), Yoga, and Qigong) in clinically KOA patients.
We searched PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database from inception to 25 April 2024. Randomized clinical trials (RCTs) that compare different MBE interventions (Pilates, TC, Yoga, and Qigong) for pain, physical function and quality of life (QoL) among patients with KOA were eligible.
A total of 38 studies (N=2561 participants) were eligible for qualitative synthesis and 38 (pain), 36 (physical function) for NMA. Pilates [standardized mean difference (SMD) = −1.19, 95% confidence intervals (95% CI): −1.92 to −0.46], TC (SMD = −0.78, 95% CI: −0.97 to −0.59), Yoga (SMD = −0.76, 95% CI: −1.15 to −0.36) and Qigong (SMD = −0.70, 95% CI: −1.94 to −0.47) demonstrated remarkable efficacy in pain reduction compared with the no treatment group. For physical function, Pilates (SMD = −1.37, 95% CI: −2.13 to −0.50), TC (SMD = −0.85, 95% CI: −1.08 to −0.63), Yoga (SMD = −0.80, 95% CI: −1.24 to −0.36) and Qigong (SMD = −0.75, 95% CI: −1.08 to −0.42) showed statistically significant efficacy compared with the no treatment group. For QoL, TC (SMD = -0.57, 95% CI = (1.07 to 0.06) showed statistically significant efficacy compared with the usual care group. According to the surface under the cumulative ranking analysis (SUCRA), Pilates achieved the highest effectiveness for improving pain (92.9%) and physical function (93.2%), TC (81.7%) achieved highest effectiveness for improving quality of life. Moreover, the interpretation of the combined results requires caution in view of the inconsistency of the evidence and the assessments of certainty.
This NMA shows that Pilates can be considered a priority choice for KOA in improving pain and physical function. TC ranks second only to Pilates, with Yoga and Qigong following. Moreover, TC achieved the highest effectiveness for improving quality of life and deserves to be promoted for clinical use. In future researches, more high-quality and adequate sample size RCTs should be conducted.
Our study provides richer options for KOA management and more evidence for MBE treatment of KOA.Our NMA shows that Pilates might be the best MBE therapy for the non-pharmacologic treatment of KOA in pain intensity and physical function，TC for QoL.
mind body exercise
Network meta-analysis
