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Network Meta-Analysis of Various Nonpharmacological Interventions on Pain Relief in Older Adults With Osteoarthritis

Zhang, Qi, MD; Young, Lufei, PhD; Li, Feng, PhD

American Journal of Physical Medicine & Rehabilitation: June 2019 - Volume 98 - Issue 6 - p 469–478
doi: 10.1097/PHM.0000000000001130
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To compare the effectiveness of different nonpharmacological interventions on pain relief in older adults with osteoarthritis, literature databases, bibliographies, and other relevant sources were searched. No language limitations were applied. Thirty-two trials published from 1997 to 2017 were included in the systematic review and network meta-analyses. We included only randomized controlled trials and studies that evaluated the effects of nonpharmacological interventions on alleviating pain in elderly adults (age ≥60 yrs or mean age > 65 yrs) who experience osteoarthritis, irrespective of sex. In the network meta-analysis, resistance training was ranked as the most effective among all nonpharmacological interventions (surface under the cumulative ranking = 82.9%, standardized mean difference = 1.96, confidence interval = −1.39 to 5.31). In subgroup analyses, resistance training still ranked the most effective pain reduction intervention, followed by strengthening exercise and yoga. Among female subjects with intervention adherence rate more than 90%, the most effective intervention was yoga. Strengthening exercise was superior to all other forms of interventions when comparing long-term effect of selected interventions. Among older adults with osteoarthritis, resistance training can be considered a treatment option for pain relief. Yoga is an effective intervention strategy for female elderly, and strengthening exercise has a better long-term beneficial effect.

From the School of Nursing, Jilin University, Jilin, China (QZ, FL); and College of Nursing, Augusta University, Augusta, Georgia (LY).

All correspondence should be addressed to: Feng Li, PhD, College of Nursing, Jilin University, Changchun 130021, Jilin Province, China.

QZ as the first author of the article have contributed the essential part of this manuscript. LY and FL assisted literature review, data management and analysis, interpretation, and multiple revisions of the draft critically. All co-authors gave the final approval of the version being submitted. We are accountable for the accuracy and integrity of all aspects of the article.

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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