A sweeping review of 217 clinical trials involving more than 15,000 participants has produced the clearest guidance yet on which types of exercise are most effective for people living with knee osteoarthritis, and the answer turns out to be accessible, inexpensive, and available to almost anyone: walking, cycling, and swimming. The study, published in The BMJ, analyzed randomized trials conducted between 1990 and 2024 and found that aerobic exercise consistently outperformed all other exercise types, including strength training, mind-body approaches, and mixed programs, in reducing pain, improving physical function, boosting walking ability, and enhancing overall quality of life. Knee osteoarthritis affects nearly 30 percent of adults over 45, and about half of those people experience severe symptoms, making it one of the most common sources of chronic pain and mobility loss in older adults. The researchers now recommend aerobic exercise as the first-line intervention for managing the condition, particularly for people whose primary goals are reducing pain and improving their ability to move.
Other forms of exercise still showed meaningful benefits and the study recommends using them alongside aerobic activity rather than replacing it. Mind-body practices improved short-term function and neuromotor training helped short-term gait performance, while strength training and mixed programs showed benefits at the 12-week mark. One of the most practically important findings was that none of the exercise types studied were associated with an increased risk of adverse events, directly addressing a common concern among patients and clinicians that movement might make the condition worse. The researchers said the evidence gives clinicians the clearest basis yet for recommending a specific form of exercise to patients with knee osteoarthritis, and emphasized that for people who find aerobic exercise difficult, other structured movement still provides meaningful relief and is always better than inactivity.
Source: https://www.sciencedaily.com/releases/2026/04/260430032411.htm
