Moderators of the Effects of Exercise and Manual Therapy for People With Knee and Hip Osteoarthritis: A Secondary Analysis of a Randomized Clinical Trial.
Arthritis Care Res (Hoboken)Apr 17, 2026 (epub)
Daniel Cury Ribeiro, Sarah E Lamb, J Haxby Abbott
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In 30 seconds
This secondary analysis of a randomized clinical trial examined how moderators like BMI and mental health influence the effectiveness of manual therapy and exercise on pain and function in 206 individuals with knee and/or hip osteoarthritis. The study found that higher BMI significantly moderated the treatment effects on WOMAC scores, indicating improved outcomes with increasing BMI for manual therapy compared to usual care.
Key findings
- BMI moderated treatment effects on WOMAC composite score (β -4.1, 95% CI -6.6 to -1.7).
- BMI also moderated function (β -3.3, 95% CI -5.1 to -1.6) and pain scores (β -0.6, 95% CI -1.3 to 0.0).
- Mental health moderated treatment effects of manual therapy (β 16.8, 95% CI 2.2-31.4).
Why it matters
Understanding how individual factors like BMI and mental health influence treatment outcomes can help clinicians tailor interventions for patients with knee and hip osteoarthritis, potentially improving pain management and functional recovery.