COMBINED aerobic and resistance exercise can produce the largest short-term pain reduction for patients with knee osteoarthritis (OA), new findings show. A Bayesian network meta-analysis of 35 randomized controlled trials involving 3,808 patients found that pairing aerobic and resistance training delivered the strongest effects on pain, function, and quality of life over 12 weeks or less. The findings give clinicians a clearer view of which exercise for knee osteoarthritis may matter most, and for how long.
Investigators searched eight major databases from inception through July 2025 for randomized trials of exercise interventions in patients with knee OA. Using random-effects models, the team compared aerobic exercise, resistance exercise, and combined programs at the short term (12 weeks or less) and the long term (more than 12 weeks). Interventions were ranked by the surface under the cumulative ranking curve, and certainty of evidence was graded with the GRADE framework.
For pain, short-term combined aerobic and resistance exercise had the largest effect among the interventions (standardized mean difference [SMD] −0.937, low certainty). It also showed the largest effect estimates for function (SMD −0.590, low certainty), followed by long-term aerobic exercise (SMD −0.540, very low certainty). For quality of life, the short-term combined approach again had the largest effect (SMD 0.663, low certainty).
Aerobic and resistance exercise, alone or in combination and delivered over the short or long term, improved pain, function, and quality of life. Short-term combined exercise produced clinically meaningful improvements in pain, with relatively favorable effects on function and quality of life. Evidence on the clinical significance of long-term exercise programs was limited, and the low to very low certainty ratings mean the estimates should be interpreted with caution. For clinicians counseling patients with knee OA, the results point toward including both aerobic and resistance components in exercise prescriptions while acknowledging the gaps in long-term data.
Reference
Yang Y et al. Effects of Exercise Type and Duration on Pain, Function, and Quality of Life in Patients With Knee Osteoarthritis: A Systematic Review With Bayesian Network Meta-Analysis. J Orthop Sports Phys Ther. 2026;56(11):724-734.
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