The Effectiveness of closed kinetic chain exercises in individuals with knee osteoarthritis: A systematic review and meta-analysis.

<h4>Introduction</h4>The aims of this review was to investigate the effectiveness of closed kinetic chain exercise (CKCE) on pain, function, and proprioception in individuals with knee osteoarthritis (OA).<h4>Methods</h4>Nine databases were searched up to December 2023. Rando...

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Main Authors: Ammar Fadil, Qassim Ibrahim Muaidi, Mohamed Salaheldien Alayat, Nahla Ahmad AlMatrafi, Moayad Saleh Subahi, Mansour Abdullah Alshehri
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0322475
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author Ammar Fadil
Qassim Ibrahim Muaidi
Mohamed Salaheldien Alayat
Nahla Ahmad AlMatrafi
Moayad Saleh Subahi
Mansour Abdullah Alshehri
author_facet Ammar Fadil
Qassim Ibrahim Muaidi
Mohamed Salaheldien Alayat
Nahla Ahmad AlMatrafi
Moayad Saleh Subahi
Mansour Abdullah Alshehri
author_sort Ammar Fadil
collection DOAJ
description <h4>Introduction</h4>The aims of this review was to investigate the effectiveness of closed kinetic chain exercise (CKCE) on pain, function, and proprioception in individuals with knee osteoarthritis (OA).<h4>Methods</h4>Nine databases were searched up to December 2023. Randomized controlled trials (RCTs) examining the effects of CKCE in individuals with knee OA were included. The methodological quality was assessed using the PEDro scale, and the level of evidence was evaluated with the GRADE system. A random-effects meta-analysis was conducted to assess differences between treatment groups for the primary outcomes (pain and function). Effect sizes were calculated using standardized mean differences (SMDs) with 95% confidence intervals (CIs).<h4>Results</h4>A total of 24 studies were included in the descriptive analysis, and 18 studies were included in the quantitative analysis (meta-analysis). The meta-analysis results indicated that CKCE treatment led to greater improvements in pain (SMD = -0.76; 95% CI: -1.51, -0.01) and function (SMD = -1.25; 95% CI: -1.88, -0.62) compared to no treatment. A subgroup meta-analysis showed that the combined treatment of CKCE and conventional physical therapy (CPT) resulted in greater improvements in pain (SMD = -1.18; 95% CI: -1.70, -0.67) and function (SMD = -1.27; 95% CI: -1.79, -0.75) compared to CPT alone. The risk of bias assessment revealed that two studies were of low quality, nine were of fair quality, and the remaining 13 were of high quality. The GRADE system indicated a low quality of evidence for the effects of CKCE on both pain and function.<h4>Conclusion</h4>While CKCE shows promise in reducing pain and improving function in individuals with knee OA, the quality of evidence is considered low according to the GRADE system. Further high-quality RCTs with larger sample sizes are needed to confirm the effectiveness of CKCE in managing knee OA.
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spelling doaj-art-d45235dc7a9945f3a9de5375a6f9aa0a2025-08-20T02:15:24ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01205e032247510.1371/journal.pone.0322475The Effectiveness of closed kinetic chain exercises in individuals with knee osteoarthritis: A systematic review and meta-analysis.Ammar FadilQassim Ibrahim MuaidiMohamed Salaheldien AlayatNahla Ahmad AlMatrafiMoayad Saleh SubahiMansour Abdullah Alshehri<h4>Introduction</h4>The aims of this review was to investigate the effectiveness of closed kinetic chain exercise (CKCE) on pain, function, and proprioception in individuals with knee osteoarthritis (OA).<h4>Methods</h4>Nine databases were searched up to December 2023. Randomized controlled trials (RCTs) examining the effects of CKCE in individuals with knee OA were included. The methodological quality was assessed using the PEDro scale, and the level of evidence was evaluated with the GRADE system. A random-effects meta-analysis was conducted to assess differences between treatment groups for the primary outcomes (pain and function). Effect sizes were calculated using standardized mean differences (SMDs) with 95% confidence intervals (CIs).<h4>Results</h4>A total of 24 studies were included in the descriptive analysis, and 18 studies were included in the quantitative analysis (meta-analysis). The meta-analysis results indicated that CKCE treatment led to greater improvements in pain (SMD = -0.76; 95% CI: -1.51, -0.01) and function (SMD = -1.25; 95% CI: -1.88, -0.62) compared to no treatment. A subgroup meta-analysis showed that the combined treatment of CKCE and conventional physical therapy (CPT) resulted in greater improvements in pain (SMD = -1.18; 95% CI: -1.70, -0.67) and function (SMD = -1.27; 95% CI: -1.79, -0.75) compared to CPT alone. The risk of bias assessment revealed that two studies were of low quality, nine were of fair quality, and the remaining 13 were of high quality. The GRADE system indicated a low quality of evidence for the effects of CKCE on both pain and function.<h4>Conclusion</h4>While CKCE shows promise in reducing pain and improving function in individuals with knee OA, the quality of evidence is considered low according to the GRADE system. Further high-quality RCTs with larger sample sizes are needed to confirm the effectiveness of CKCE in managing knee OA.https://doi.org/10.1371/journal.pone.0322475
spellingShingle Ammar Fadil
Qassim Ibrahim Muaidi
Mohamed Salaheldien Alayat
Nahla Ahmad AlMatrafi
Moayad Saleh Subahi
Mansour Abdullah Alshehri
The Effectiveness of closed kinetic chain exercises in individuals with knee osteoarthritis: A systematic review and meta-analysis.
PLoS ONE
title The Effectiveness of closed kinetic chain exercises in individuals with knee osteoarthritis: A systematic review and meta-analysis.
title_full The Effectiveness of closed kinetic chain exercises in individuals with knee osteoarthritis: A systematic review and meta-analysis.
title_fullStr The Effectiveness of closed kinetic chain exercises in individuals with knee osteoarthritis: A systematic review and meta-analysis.
title_full_unstemmed The Effectiveness of closed kinetic chain exercises in individuals with knee osteoarthritis: A systematic review and meta-analysis.
title_short The Effectiveness of closed kinetic chain exercises in individuals with knee osteoarthritis: A systematic review and meta-analysis.
title_sort effectiveness of closed kinetic chain exercises in individuals with knee osteoarthritis a systematic review and meta analysis
url https://doi.org/10.1371/journal.pone.0322475
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