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Comparison 1 All included studies, Outcome 1 Pain.
Figuras y tablas -
Analysis 1.1

Comparison 1 All included studies, Outcome 1 Pain.

Comparison 1 All included studies, Outcome 2 Physical function.
Figuras y tablas -
Analysis 1.2

Comparison 1 All included studies, Outcome 2 Physical function.

Comparison 2 Treatment content, Outcome 1 Pain.
Figuras y tablas -
Analysis 2.1

Comparison 2 Treatment content, Outcome 1 Pain.

Comparison 2 Treatment content, Outcome 2 Physical Function.
Figuras y tablas -
Analysis 2.2

Comparison 2 Treatment content, Outcome 2 Physical Function.

Comparison 3 Treatment delivery mode, Outcome 1 Pain.
Figuras y tablas -
Analysis 3.1

Comparison 3 Treatment delivery mode, Outcome 1 Pain.

Comparison 3 Treatment delivery mode, Outcome 2 Physical Function.
Figuras y tablas -
Analysis 3.2

Comparison 3 Treatment delivery mode, Outcome 2 Physical Function.

Comparison 4 Number of contact occasions, Outcome 1 Pain.
Figuras y tablas -
Analysis 4.1

Comparison 4 Number of contact occasions, Outcome 1 Pain.

Comparison 4 Number of contact occasions, Outcome 2 Physical Function.
Figuras y tablas -
Analysis 4.2

Comparison 4 Number of contact occasions, Outcome 2 Physical Function.

Comparison 5 Blinding of outcomes assessment, Outcome 1 Pain.
Figuras y tablas -
Analysis 5.1

Comparison 5 Blinding of outcomes assessment, Outcome 1 Pain.

Comparison 5 Blinding of outcomes assessment, Outcome 2 Physical Function.
Figuras y tablas -
Analysis 5.2

Comparison 5 Blinding of outcomes assessment, Outcome 2 Physical Function.

Comparison 6 Statistical analysis method, Outcome 1 Pain.
Figuras y tablas -
Analysis 6.1

Comparison 6 Statistical analysis method, Outcome 1 Pain.

Comparison 6 Statistical analysis method, Outcome 2 Physical Function.
Figuras y tablas -
Analysis 6.2

Comparison 6 Statistical analysis method, Outcome 2 Physical Function.

Comparison 7 Allocation concealment, Outcome 1 Pain.
Figuras y tablas -
Analysis 7.1

Comparison 7 Allocation concealment, Outcome 1 Pain.

Comparison 7 Allocation concealment, Outcome 2 Physical Function.
Figuras y tablas -
Analysis 7.2

Comparison 7 Allocation concealment, Outcome 2 Physical Function.

Comparison 8 Estimated risk of bias, Outcome 1 Pain.
Figuras y tablas -
Analysis 8.1

Comparison 8 Estimated risk of bias, Outcome 1 Pain.

Comparison 8 Estimated risk of bias, Outcome 2 Physical Function.
Figuras y tablas -
Analysis 8.2

Comparison 8 Estimated risk of bias, Outcome 2 Physical Function.

Comparison 9 Sample size, Outcome 1 Pain.
Figuras y tablas -
Analysis 9.1

Comparison 9 Sample size, Outcome 1 Pain.

Comparison 9 Sample size, Outcome 2 Physical function.
Figuras y tablas -
Analysis 9.2

Comparison 9 Sample size, Outcome 2 Physical function.

Comparison 10 Clinical Relevance, Outcome 1 WOMAC Pain.
Figuras y tablas -
Analysis 10.1

Comparison 10 Clinical Relevance, Outcome 1 WOMAC Pain.

Comparison 10 Clinical Relevance, Outcome 2 VAS Pain.
Figuras y tablas -
Analysis 10.2

Comparison 10 Clinical Relevance, Outcome 2 VAS Pain.

Comparison 10 Clinical Relevance, Outcome 3 WOMAC Function.
Figuras y tablas -
Analysis 10.3

Comparison 10 Clinical Relevance, Outcome 3 WOMAC Function.

Table 1. Clinical Relevance: WOMAC Pain

Outcome (scale)

# patients (#trials)

Control baseline m*

Wt absolute change

Relative % change

NNT(B)

Statistical signific

Quality of evidence

Improvement in knee pain (WOMAC 0‐20)

1869 (13)

7.4*

5.2% (1.0 fewer points on a 0‐20 scale)

14.1% (I)

7

Statistically significant

Platinum

95% CI

*Thomas 2002

(3.6%, 6.8%)

(10.3%, 18.5%)

Figuras y tablas -
Table 1. Clinical Relevance: WOMAC Pain
Table 2. Clinical Relevance: VAS Pain

Outcome (scale)

# patients (#trials)

Control baseline m*

Wt absolute change

Relative % change

NNT(B)

Statist significance

Quality of evidence

Improvement in knee pain (VAS 0‐10)

669 (8)

5.2*

7.5% (0.75 fewer points on a 0‐10 scale)

14.4% (I)

6

Statistically significant

Platinum

*(Bennell 2005)

(4.8%, 10%)

(9.2%, 19.3%)

Figuras y tablas -
Table 2. Clinical Relevance: VAS Pain
Table 3. Clinical relevance: WOMAC Physical function

Outcome (scale)

# patients (#trials)

Control baseline m*

Wt absolute change

Relative % change

NNT(B)

Statist significance

Quality of evidence

Improvement in physical function (WOMAC 0‐68)

2275 (16)

23.0*

3.9% (2.6 fewer points on a 0‐68 scale)

11.4% (I)

8

Statistically significant

Platinum

(*Thomas 2002)

(2.6%, 5.3%)

(7.8%, 15.5%)

Figuras y tablas -
Table 3. Clinical relevance: WOMAC Physical function
Comparison 1. All included studies

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Pain Show forest plot

32

3616

Std. Mean Difference (IV, Random, 95% CI)

‐0.40 [‐0.50, ‐0.30]

2 Physical function Show forest plot

31

3719

Std. Mean Difference (IV, Random, 95% CI)

‐0.37 [‐0.49, ‐0.25]

Figuras y tablas -
Comparison 1. All included studies
Comparison 2. Treatment content

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Pain Show forest plot

32

3616

Std. Mean Difference (IV, Random, 95% CI)

‐0.40 [‐0.50, ‐0.30]

1.1 Simple quadriceps strengthening

3

319

Std. Mean Difference (IV, Random, 95% CI)

‐0.29 [‐0.51, ‐0.06]

1.2 Lower limb muscle strengthening

9

1383

Std. Mean Difference (IV, Random, 95% CI)

‐0.53 [‐0.79, ‐0.27]

1.3 Strengthening and aerobic

9

998

Std. Mean Difference (IV, Random, 95% CI)

‐0.40 [‐0.61, ‐0.19]

1.4 Walking program

4

351

Std. Mean Difference (IV, Random, 95% CI)

‐0.48 [‐0.83, ‐0.13]

1.5 Other

7

565

Std. Mean Difference (IV, Random, 95% CI)

‐0.32 [‐0.49, ‐0.15]

2 Physical Function Show forest plot

31

3719

Std. Mean Difference (IV, Random, 95% CI)

‐0.37 [‐0.49, ‐0.25]

2.1 Simple quadriceps strengthening

4

498

Std. Mean Difference (IV, Random, 95% CI)

‐0.24 [‐0.42, ‐0.06]

2.2 Lower limb muscle strengthening

9

1383

Std. Mean Difference (IV, Random, 95% CI)

‐0.58 [‐0.88, ‐0.27]

2.3 Strengthening and aerobic

8

967

Std. Mean Difference (IV, Random, 95% CI)

‐0.42 [‐0.65, ‐0.18]

2.4 Walking program

3

317

Std. Mean Difference (IV, Random, 95% CI)

‐0.35 [‐0.58, ‐0.11]

2.5 Other

7

554

Std. Mean Difference (IV, Random, 95% CI)

‐0.22 [‐0.48, 0.05]

Figuras y tablas -
Comparison 2. Treatment content
Comparison 3. Treatment delivery mode

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Pain Show forest plot

32

3717

Std. Mean Difference (IV, Random, 95% CI)

‐0.40 [‐0.50, ‐0.30]

1.1 Individual treatments

10

849

Std. Mean Difference (IV, Random, 95% CI)

‐0.55 [‐0.81, ‐0.29]

1.2 Class‐based programs

17

1608

Std. Mean Difference (IV, Random, 95% CI)

‐0.37 [‐0.51, ‐0.24]

1.3 Home program

6

1260

Std. Mean Difference (IV, Random, 95% CI)

‐0.28 [‐0.39, ‐0.16]

2 Physical Function Show forest plot

31

3820

Std. Mean Difference (IV, Random, 95% CI)

‐0.36 [‐0.48, ‐0.25]

2.1 Individual treatments

10

849

Std. Mean Difference (IV, Random, 95% CI)

‐0.52 [‐0.86, ‐0.19]

2.2 Class‐based programs

16

1563

Std. Mean Difference (IV, Random, 95% CI)

‐0.35 [‐0.50, ‐0.19]

2.3 Home program

6

1408

Std. Mean Difference (IV, Random, 95% CI)

‐0.28 [‐0.38, ‐0.17]

Figuras y tablas -
Comparison 3. Treatment delivery mode
Comparison 4. Number of contact occasions

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Pain Show forest plot

32

3616

Std. Mean Difference (IV, Random, 95% CI)

‐0.40 [‐0.50, ‐0.30]

1.1 Less than 12 occasions

9

1594

Std. Mean Difference (IV, Random, 95% CI)

‐0.28 [‐0.40, ‐0.16]

1.2 12 or more occasions

23

2022

Std. Mean Difference (IV, Random, 95% CI)

‐0.46 [‐0.60, ‐0.32]

2 Physical Function Show forest plot

31

3719

Std. Mean Difference (IV, Random, 95% CI)

‐0.37 [‐0.49, ‐0.25]

2.1 Less than 12 occasions

9

1731

Std. Mean Difference (IV, Random, 95% CI)

‐0.23 [‐0.37, ‐0.09]

2.2 12 or more occasions

22

1988

Std. Mean Difference (IV, Random, 95% CI)

‐0.45 [‐0.62, ‐0.29]

Figuras y tablas -
Comparison 4. Number of contact occasions
Comparison 5. Blinding of outcomes assessment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Pain Show forest plot

32

3616

Std. Mean Difference (IV, Random, 95% CI)

‐0.40 [‐0.50, ‐0.30]

1.1 Blinded assessment

18

2559

Std. Mean Difference (IV, Random, 95% CI)

‐0.33 [‐0.43, ‐0.22]

1.2 Uncertain/unblinded assessment

14

1057

Std. Mean Difference (IV, Random, 95% CI)

‐0.53 [‐0.73, ‐0.33]

2 Physical Function Show forest plot

31

3719

Std. Mean Difference (IV, Random, 95% CI)

‐0.37 [‐0.49, ‐0.25]

2.1 Blinded assessment

19

2730

Std. Mean Difference (IV, Random, 95% CI)

‐0.28 [‐0.39, ‐0.17]

2.2 Uncertain/unblinded assessment

12

989

Std. Mean Difference (IV, Random, 95% CI)

‐0.55 [‐0.83, ‐0.28]

Figuras y tablas -
Comparison 5. Blinding of outcomes assessment
Comparison 6. Statistical analysis method

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Pain Show forest plot

32

3616

Std. Mean Difference (IV, Random, 95% CI)

‐0.40 [‐0.50, ‐0.30]

1.1 Intention to treat

14

2394

Std. Mean Difference (IV, Random, 95% CI)

‐0.36 [‐0.51, ‐0.21]

1.2 Efficacy

18

1222

Std. Mean Difference (IV, Random, 95% CI)

‐0.45 [‐0.58, ‐0.32]

2 Physical Function Show forest plot

31

3719

Std. Mean Difference (IV, Random, 95% CI)

‐0.37 [‐0.49, ‐0.25]

2.1 Intention to treat

15

2576

Std. Mean Difference (IV, Random, 95% CI)

‐0.30 [‐0.45, ‐0.16]

2.2 Efficacy

16

1143

Std. Mean Difference (IV, Random, 95% CI)

‐0.43 [‐0.64, ‐0.23]

Figuras y tablas -
Comparison 6. Statistical analysis method
Comparison 7. Allocation concealment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Pain Show forest plot

32

3801

Std. Mean Difference (IV, Random, 95% CI)

‐0.40 [‐0.50, ‐0.30]

1.1 Adequate allocation concealment

14

2599

Std. Mean Difference (IV, Random, 95% CI)

‐0.33 [‐0.44, ‐0.23]

1.2 Unclear allocation concealment

18

1202

Std. Mean Difference (IV, Random, 95% CI)

‐0.49 [‐0.66, ‐0.32]

2 Physical Function Show forest plot

31

3719

Std. Mean Difference (IV, Random, 95% CI)

‐0.37 [‐0.49, ‐0.25]

2.1 Adequate allocation concealment

15

2596

Std. Mean Difference (IV, Random, 95% CI)

‐0.28 [‐0.38, ‐0.18]

2.2 Unclear allocation concealment

16

1123

Std. Mean Difference (IV, Random, 95% CI)

‐0.48 [‐0.73, ‐0.23]

Figuras y tablas -
Comparison 7. Allocation concealment
Comparison 8. Estimated risk of bias

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Pain Show forest plot

32

3616

Std. Mean Difference (IV, Random, 95% CI)

‐0.40 [‐0.50, ‐0.30]

1.1 Low risk of bias

10

2021

Std. Mean Difference (IV, Random, 95% CI)

‐0.28 [‐0.42, ‐0.15]

1.2 Moderate risk of bias

13

972

Std. Mean Difference (IV, Random, 95% CI)

‐0.48 [‐0.67, ‐0.29]

1.3 High risk of bias

9

623

Std. Mean Difference (IV, Random, 95% CI)

‐0.51 [‐0.72, ‐0.30]

2 Physical Function Show forest plot

31

3719

Std. Mean Difference (IV, Random, 95% CI)

‐0.37 [‐0.49, ‐0.25]

2.1 Low risk of bias

10

2024

Std. Mean Difference (IV, Random, 95% CI)

‐0.25 [‐0.38, ‐0.13]

2.2 Moderate risk of bias

14

1140

Std. Mean Difference (IV, Random, 95% CI)

‐0.39 [‐0.60, ‐0.18]

2.3 High risk of bias

7

555

Std. Mean Difference (IV, Random, 95% CI)

‐0.55 [‐0.90, ‐0.21]

Figuras y tablas -
Comparison 8. Estimated risk of bias
Comparison 9. Sample size

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Pain Show forest plot

32

3616

Std. Mean Difference (IV, Random, 95% CI)

‐0.40 [‐0.50, ‐0.30]

1.1 n>50 in each allocation

9

2120

Std. Mean Difference (IV, Random, 95% CI)

‐0.29 [‐0.42, ‐0.16]

1.2 25<n<50 in any allocation

12

1099

Std. Mean Difference (IV, Random, 95% CI)

‐0.43 [‐0.57, ‐0.28]

1.3 n<25 in any allocation

11

397

Std. Mean Difference (IV, Random, 95% CI)

‐0.63 [‐0.92, ‐0.34]

2 Physical function Show forest plot

31

3719

Std. Mean Difference (IV, Random, 95% CI)

‐0.37 [‐0.49, ‐0.25]

2.1 n>50 in each allocation

10

2302

Std. Mean Difference (IV, Random, 95% CI)

‐0.24 [‐0.33, ‐0.16]

2.2 25< n<50 in any allocation

12

1088

Std. Mean Difference (IV, Random, 95% CI)

‐0.43 [‐0.66, ‐0.20]

2.3 n>25 in any allocation

9

329

Std. Mean Difference (IV, Random, 95% CI)

‐0.63 [‐1.04, ‐0.22]

Figuras y tablas -
Comparison 9. Sample size
Comparison 10. Clinical Relevance

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 WOMAC Pain Show forest plot

14

2051

Std. Mean Difference (IV, Random, 95% CI)

‐0.35 [‐0.48, ‐0.21]

2 VAS Pain Show forest plot

8

669

Std. Mean Difference (IV, Random, 95% CI)

‐0.43 [‐0.65, ‐0.21]

3 WOMAC Function Show forest plot

17

2460

Std. Mean Difference (IV, Random, 95% CI)

‐0.28 [‐0.39, ‐0.17]

Figuras y tablas -
Comparison 10. Clinical Relevance