Evaluation of Traditional Chinese Exercise for Knee Osteoarthritis (KOA): an overview of systematic reviews

Abstract

Abstract Background Knee osteoarthritis (KOA) has become an issue of public health. Several Systematic Reviews and Meta-analyses (SRs/Mas) indicate that Traditional Chinese Exercise (TCE) may be an effective treatment for reducing pain, stiffness, and physical function in people with knee osteoarthritis (KOA). Objectives To re-evaluate the literature quality and the evidence for the systematic evaluation of TCE for osteoarthritis of the knee and to offer evidence to support the clinical practice of TCE for osteoarthritis of the knee. Methods Eight electronic databases will be used to retrieve literature from their inception to January 3, 2023, including China National Knowledge Infrastructure (CNKI), Wanfang database (WF), Chinese Scientific Journals Database (VIP), China Biomedical database (CBM), PubMed, EMBASE, Web of Science and Cochrane Library, without restrictions on the study date or language, a systematic evaluation/Meta-analysis of commonly used TCE for knee osteoarthritis was compiled, the methodological and reporting quality of the included literature was evaluated using the AMSTAR-2 scale and PRISMA 2020, and the quality of the evidence was assessed using the GRADE classification. Results A total of 18 papers were included, and the AMSTAR-2 review revealed that the literature's methodological quality could have been better. The study of RPISMA 2020 indicated that the overall reporting standards were deficient. The quality of Chinese and English literature differed, with English literature being superior in methodological quality and reporting quality. There were a total of 93 pieces of evidence obtained, 46 of which were of very low quality (49.46%, 46/93), 34 of low quality (36.56%, 34/93), 13 of medium level (13.98%, 13/93), and none of the high quality. TCE was supported by 76 pieces of evidence (81.72%, 76/93). Conclusion TCE is, therefore, advantageous and secure for KOA. However, clinicians should proceed from these findings with caution in their practice due to the relatively low methodological and evidentiary quality of the included SRs/MAs.