Effects of cycling rehabilitation training on patients with knee osteoarthritis: A systematic review and meta‑analysis

Abstract Studies have shown that individuals with knee osteoarthritis (KOA) may benefit from cycling exercise. However, the supportive evidence remains unclear. This systematic review aimed to investigate the effects of cycling rehabilitation training (CRT) on the recovery of osteoarthritic knee joints. Five databases were searched with publishing date restrictions from 1 January 2000 to 1 March 2022. We included studies that 1) recruited participants with KOA, 2) used CRT in the intervention, 3) compared measurements before and after the intervention or between a KOA group and a healthy group, and 4) included the measurements of interest. The quality of the studies was assessed using the modified Downs and Black checklist. A random-effects meta-analysis of Western Ontario and McMaster Universities Arthritis index, Lequesne index, and Timed Up and Go test scores was performed. The changes in muscle strength, kinetics, and kinematics as a result of the intervention were summarised. The quality of the 19 included studies was moderate with a median quality score of 19.05. CRT improved muscle strength and physical function (SMD 0.94, 95% CI [0.66, 1.22]), and reduce pain (SMD 0.94, 95% CI [0.66, 1.22]) and joint stiffness (SMD 0.74, 95% CI [0.46, 1.01]) in KOA patients. Compared with healthy subjects, KOA patients showed increased extensor moments and abduction peak adduction angles of their knee joints, and decreased internal rotation moment and peak angles of knee flexion and extension. CRT was effective in relieving knee pain, restoring motor function, and improving lower limb muscle strength. Knee abduction moment may be an indicator of rehabilitation progress.