International Journal of Medical Discoveries

The global burden of MSCs is considerable as they are responsible for a high level of disability, cost to healthcare systems, and reduced quality of life. Exercise therapy is a fundamental aspect of physical therapy for the management of MSCs, but it is of variable effectiveness across different conditions, and optimal prescription parameters for these therapies remain unclear. This paper aims to provide a synthesis of systematic review-level evidence for land-based exercise therapy for eight musculoskeletal conditions (fibromyalgia, low back pain, neck pain, shoulder pain, knee and hip osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and osteoporosis) from the available literature. A systematic search of the Cochrane Database, MEDLINE, EMBASE, CINAHL, AMED, and PEDro databases was conducted for systematic reviews published before 2012. The methodological quality of the systematic reviews was assessed with the AMSTAR checklist. Data regarding pain, physical function, pathophysiology of the condition, and exercise prescription parameters were extracted from the systematic reviews and narrated. Nine systematic literature reviews were examined (see Table 1). Evidence exists to support exercise treatment for the majority of musculoskeletal conditions (MSCs), with small to moderate benefits of exercise on pain and function. The most robust evidence exists for osteoarthritis (OA) of the knee, chronic low back pain, fibromyalgia, and shoulder pain. While the evidence is mixed for neck pain, hip OA, rheumatoid arthritis, and ankylosing spondylitis, the body of literature is limited for those conditions. In osteoporosis (OP), exercise does show a significant increase in bone mineral density at the lumbar spine (0.85%) and greater trochanter (1.03%). The dosage and supervision of exercise can influence outcomes such that for knee OA and chronic low back pain, there seems to be a greater effect being received from individuals enrolled in exercise programs consisting of ≥12 supervised sessions. Clinicians should ensure that their patients receive an adequate dosage of exercise, which is appropriately supervised, when treating knee OA and chronic low back pain. Future research on exercise prescription will require randomised trials of high-quality, study the mechanistic effects, and long-term follow-up to establish optimal exercise prescription and disease-modifying effects.