Research Summary
Aerobic Plus Strength Exercise Gave the Biggest Short-Term Pain Relief for Knee Arthritis, Review of 35 Trials Finds
Walking-style aerobic exercise and strength training both helped people with knee osteoarthritis, and doing the two together over 12 weeks or less showed the largest pain relief, according to a new review of 35 trials. The systematic review with Bayesian network meta-analysis was published in the Journal of Orthopaedic & Sports Physical Therapy.
What was studied
Exercise is a first-line treatment for knee arthritis, but people often ask which kind works best and for how long. The researchers searched eight medical databases through July 2025 for randomized controlled trials of exercise in knee osteoarthritis. A network meta-analysis lets researchers compare several approaches at once, even when not every pair was tested head to head.
They included 35 trials with 3,808 patients and compared aerobic exercise, resistance (strength) exercise and combined programs, split into short-term (12 weeks or less) and long-term (more than 12 weeks).
Key findings
- Aerobic and resistance exercise, alone or combined, short- or long-term, all improved pain, function and quality of life.
- Short-term combined aerobic and strength exercise had the largest effect on pain, which the authors judged clinically meaningful.
- The same short-term combined approach also ranked best for function and quality of life, followed for function by long-term aerobic exercise.
What it means for people with knee pain
Any of these types of exercise can help, so the best program is one you will actually do. If you can, mixing something aerobic, such as walking or cycling, with leg strengthening may give the most benefit in the first few months. A physical therapist can help you build a plan that suits your knees.
Limitations
The certainty of the evidence was rated low or very low, so the rankings could change as more trials are done. Evidence on whether longer programs make a meaningful difference was limited.
Frequently asked questions
- What type of exercise is best for knee osteoarthritis?
- In this review of 35 trials, aerobic exercise, strength training and combined programs all helped. Combining aerobic and strength exercise over 12 weeks or less showed the largest pain relief, but the evidence certainty was low.
- How long do I need to exercise to feel a difference?
- Programs of 12 weeks or less produced meaningful improvements in this review. The authors said evidence on the added value of longer programs was limited.
- What counts as aerobic and resistance exercise?
- Aerobic exercise raises your heart rate, such as walking, cycling or swimming. Resistance exercise strengthens muscles, such as leg presses, squats or band exercises. A physical therapist can tailor both to your knees.
Sudden severe pain, swelling, or can't bear weight? Seek medical care promptly. In an emergency call 911.