{
    "abstract": "Knee osteoarthritis (KOA) is a prevalent chronic joint disease. Due to the risks of opioid use and limited pharmacological effectiveness, mind-body exercise (MBE) therapy and other non-pharmacological interventions have emerged as first-line treatments for this condition. However, the optimal MBE modes for KOA remain undetermined. This systematic review and network meta-analysis (NMA) aims to compare the efficacy of different MBE modes, including Pilates, Tai Chi, Yoga, and Qigong, in managing KOA.\nWe searched PubMed, Embase, Cochrane Library, Web of Science, Scopus, China National Knowledge Infrastructure (CNKI), Wanfang Database from inception to 25 April 2024. Randomized clinical trials comparing MBE interventions for pain, physical function and quality of life (QoL) in KOA patients were eligible.\u00a0The Cochrane Risk-of-Bias Tool 2.0 and Grading of Recommendations, Assessment, Development & Evaluation (GRADE) approach were used to assess literature quality and evidence certainty for each outcome.\nA total of 38 studies (N\u2009=\u20092561) were included, with 38 for pain, 36 for physical function, and 12 for QoL in the NMA. With moderate-certainty, both Pilates and TC showed significant improvements in pain reduction [Pilates: standardized mean difference (SMD)\u2009=\u2009\u2009-\u20091.19, 95% confidence intervals (95% CI):\u2009-\u20091.92 to\u2009-\u20090.46; TC: SMD\u2009=\u2009\u2009-\u20090.78, 95% CI\u2009-\u20090.97 to\u2009-\u20090.59] and physical function (Pilates: SMD\u2009=\u2009\u2009-\u20091.37, 95% CI\u2009-\u20092.13 to\u2009-\u20090.50; TC: SMD\u2009=\u2009\u2009-\u20090.85, 95% CI\u2009-\u20091.08 to\u2009-\u20090.63) compared to the usual care group, while TC [SMD\u2009=\u2009\u2009-\u20090.57, 95% CI\u2009=\u2009(-\u20091.07 to\u2009-\u20090.06)]\u00a0showed statistically significant efficacy in improving QoL compared to the usual care group.\nThere is moderate-certainty evidence that Pilates and Tai Chi may be the most effective mind-body exercises for improving pain and physical function in knee osteoarthritis, while Tai Chi may be the best for improving quality of life. These findings may help clinicians guide their prescription of exercise types with respect to treatment outcomes. The limited number of large sample studies and the few studies with low bias risk are limitations. Trial registration The protocol for NMA has been registered with PROSPERO (CRD42024531878).",
    "authors": [
        {
            "affiliation": "Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, 200000, China.\nDepartment of Rehabilitation Medicine, the Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510655, China.\nGuangdong Provincial Clinical Research Center for Rehabilitation Medicine, Guangzhou, China.\nBiomedical Innovation Center, the Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.",
            "firstname": "Kaixia",
            "initials": "K",
            "lastname": "Gao"
        },
        {
            "affiliation": "Department of Rehabilitation Medicine, the Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510655, China.\nGuangdong Provincial Clinical Research Center for Rehabilitation Medicine, Guangzhou, China.\nBiomedical Innovation Center, the Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.",
            "firstname": "Jinmeng",
            "initials": "J",
            "lastname": "Tao"
        },
        {
            "affiliation": "Postgraduate Research Institute, Guangzhou Sport University, Guangzhou, China.\nGuangdong Provincial Clinical Research Center for Rehabilitation Medicine, Guangzhou, China.\nBiomedical Innovation Center, the Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.",
            "firstname": "Guangyuan",
            "initials": "G",
            "lastname": "Liang"
        },
        {
            "affiliation": "Department of Rehabilitation Medicine, the Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510655, China.\nGuangdong Provincial Clinical Research Center for Rehabilitation Medicine, Guangzhou, China.\nBiomedical Innovation Center, the Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.",
            "firstname": "Chen",
            "initials": "C",
            "lastname": "Gong"
        },
        {
            "affiliation": "Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, 200000, China. wanglin@sus.edu.cn.",
            "firstname": "Lin",
            "initials": "L",
            "lastname": "Wang"
        },
        {
            "affiliation": "Department of Rehabilitation Medicine, the Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510655, China. wangyul@mail.sysu.edu.cn.\nGuangdong Provincial Clinical Research Center for Rehabilitation Medicine, Guangzhou, China. wangyul@mail.sysu.edu.cn.\nBiomedical Innovation Center, the Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China. wangyul@mail.sysu.edu.cn.",
            "firstname": "Yuling",
            "initials": "Y",
            "lastname": "Wang"
        }
    ],
    "conclusions": "There is moderate-certainty evidence that Pilates and Tai Chi may be the most effective mind-body exercises for improving pain and physical function in knee osteoarthritis, while Tai Chi may be the best for improving quality of life. These findings may help clinicians guide their prescription of exercise types with respect to treatment outcomes. The limited number of large sample studies and the few studies with low bias risk are limitations. Trial registration The protocol for NMA has been registered with PROSPERO (CRD42024531878).",
    "copyrights": "\u00a9 2025. The Author(s).",
    "doi": "10.1186/s13018-025-05682-7",
    "journal": "Journal of orthopaedic surgery and research",
    "keywords": [
        "Knee osteoarthritis",
        "Mind\u2013body exercises",
        "Network meta-analysis",
        "Systematic review"
    ],
    "methods": null,
    "publication_date": "2025-04-18",
    "pubmed_id": "40247321\n33406330\n31908149\n34465902\n34505846\n37675071\n38263654\n31278997\n33116279\n36493632\n34391253\n31523668\n32547187\n38639940\n38637135\n27912936\n36266755\n19361005\n22579438\n38515124\n38077287\n30830561\n37346776\n26030634\n25569281\n26513223\n34642179\n39720154\n24098547\n25393541\n26062085\n26227148\n30999738\n31462531\n24992266\n33177059\n31524502\n27183035\n30356529\n23017610\n19389743\n17264104\n12966613\n19877092\n35721018\n32188186\n18315512\n31998728\n34306416\n32931545\n32886828\n36122378\n24886638\n27913870\n29664955\n36775508\n29108873\n29351644\n20627334\n34916210\n29283899\n29427725\n20103401\n18515917\n35099429\n15605336\n19095753\n30831273\n37280700\n29563100\n20492638\n17968296\n34968719\n25066335\n34353036\n38777285\n33781857\n36204373\n32278875\n38608799\n37701842\n23585869\n35047525\n31395306\n31472246\n38753745\n28076926\n30953508\n31987253\n36419784\n28183188\n33332396\n34058100\n37641050",
    "results": null,
    "title": "Comparative efficacy of mind-body exercise for pain, function, quality of life in knee osteoarthritis: a systematic review and network meta-analysis.",
    "xml": "<Element 'PubmedArticle' at 0x788503f0fa60>"
}