Background: Many international clinical guidelines recommend therapeutic exercise as a core treatment for knee and hip osteoarthritis. We aimed to identify individual patient-level moderators of the effect of therapeutic exercise for reducing pain and improving physical function in people with knee osteoarthritis, hip osteoarthritis, or both. Methods: We did a systematic review and individual participant data (IPD) meta-analysis of randomised controlled trials comparing therapeutic exercise with non-exercise controls in people with knee osteoathritis, hip osteoarthritis, or both. We searched ten databases from March 1, 2012, to Feb 25, 2019, for randomised controlled trials comparing the effects of exercise with non-exercise or other exercise controls on pain and physical function outcomes among people with knee osteoarthritis, hip osteoarthritis, or both. IPD were requested from leads of all eligible randomised controlled trials. 12 potential moderators of interest were explored to ascertain whether they were associated with short-term (12 weeks), medium-term (6 months), and long-term (12 months) effects of exercise on self-reported pain and physical function, in comparison with non-exercise controls. Overall intervention effects were also summarised. This study is prospectively registered on PROSPERO (CRD42017054049). Findings: Of 91 eligible randomised controlled trials that compared exercise with non-exercise controls, IPD from 31 randomised controlled trials (n=4241 participants) were included in the meta-analysis. Randomised controlled trials included participants with knee osteoarthritis (18 [58%] of 31 trials), hip osteoarthritis (six [19%]), or both (seven [23%]) and tested heterogeneous exercise interventions versus heterogeneous non-exercise controls, with variable risk of bias. Summary meta-analysis results showed that, on average, compared with non-exercise controls, therapeutic exercise reduced pain on a standardised 0–100 scale (with 100 corresponding to worst pain), with a difference of –6·36 points (95% CI –8·45 to –4·27, borrowing of strength [BoS] 10·3%, between-study variance [τ2] 21·6) in the short term, –3·77 points (–5·97 to –1·57, BoS 30·0%, τ2 14·4) in the medium term, and –3·43 points (–5·18 to –1·69, BoS 31·7%, τ2 4·5) in the long term. Therapeutic exercise also improved physical function on a standardised 0–100 scale (with 100 corresponding to worst physical function), with a difference of –4·46 points in the short term (95% CI –5·95 to –2·98, BoS 10·5%, τ2 10·1), –2·71 points in the medium term (–4·63 to –0·78, BoS 33·6%, τ2 11·9), and –3·39 points in the long term (–4·97 to –1·81, BoS 34·1%, τ2 6·4). Baseline pain and physical function moderated the effect of exercise on pain and physical function outcomes. Those with higher self-reported pain and physical function scores at baseline (ie, poorer physical function) generally benefited more than those with lower self-reported pain and physical function scores at baseline, with the evidence most certain in the short term (12 weeks). Interpretation: There was evidence of a small, positive overall effect of therapeutic exercise on pain and physical function compared with non-exercise controls. However, this effect is of questionable clinical importance, particularly in the medium and long term. As individuals with higher pain severity and poorer physical function at baseline benefited more than those with lower pain severity and better physical function at baseline, targeting individuals with higher levels of osteoarthritis-related pain and disability for therapeutic exercise might be of merit. Funding: Chartered Society of Physiotherapy Charitable Trust and the National Institute for Health and Care Research.
This conversation between Geert Lovink and Nikita Lin reflects upon our inner experiences within the global networked digital cultures. It explores the tactics, aesthetic and political, in response to the breakdowns brought by digital platforms and the possibility of creating new beginnings through persistent engagement in writing and publishing. Since 2004 Lovink is heading the Institute of Network Cultures at the Amsterdam University of Applied Sciences and is Art and Network Cultures Professor of Art and Network Cultures at University of Amsterdam’s Art History Department. The conversation takes as point of departure Lovink’s three recent books: Sad by Design: On Platform Nihilism, Stuck on the Platform: Reclaiming the Internet, and Extinction Internet: Our Inconvenient Truth Moment. Over the past 30 years, Lovink has been experimenting with the networks and the internet in his writing by developing a distinct style that dig into essays, interviews, aphorisms, sloganisms, and memes. This includes critical concepts that he has developed-such as ‘tactical media,’ ‘net criticism,' ‘sad by design,’ and ‘internet extinction’ – that people recognize, find useful and ready to apply to their own activities. For Geert Lovink, the fascinating question with writing is how to capture fast-changing real-time phenomena which means not only documenting but also leaving room for anticipation.
A systematic review and meta-analysis of survey research was conducted to estimate honorary authorship prevalence in health sciences. We searched PubMed, Lens.org, and Dimensions.ai. until January 5 2023. Methodological quality was assessed and quantitative syntheses were conducted. Nineteen surveys were included and rated as having low methodological quality. We found a pooled prevalence of 26% [95% CI 21–31] (6 surveys, 2758 respondents) of researchers that perceived co-author(s) as honorary on the publication at issue (when they were not referred to any authorship criteria). That prevalence was 18% [95% CI 15–21] (11 surveys, 4272 respondents) when researchers were referred to Committee of Medical Journal Editors (ICMJE) authorship criteria, and 51% [95% CI 47–56] (15 surveys, 5111 respondents) when researchers were asked to declare their co-author(s) contributions on the publication at issue (and these were then compared to ICMJE criteria). 10% of researchers [95% CI 9–12] (11 surveys, 3,663 respondents) reported being approached by others to include honorary author(s) on the publication at issue and 16% [95% CI 13–18] (2 surveys, 823 respondents) admitted adding (an) honorary author(s). Survey research consistently indicates that honorary authorship in the health sciences is highly prevalent, however the quality of the surveys’ methods and reporting needs improvement.
MULTIFILE
