Effects of Exercise on Balance Function in People with Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Objectives: This study sought to evaluate the impact of exercise on balance function in individuals with knee osteoarthritis (KOA) and determine the most effective exercise protocols for balance enhancement. Methods: A systematic literature search was performed across five major electronic databases (PubMed, Web of Science, EBSCO, Cochrane, Scopus) until 13 September 2024. Statistical synthesis was conducted using weighted mean differences (WMDs) with 95% confidence intervals under a random-effects model. Results: Analysis of 22 studies revealed significant improvements in balance function following exercise interventions. Outcomes measured by the Berg balance scale (BBS, WMD, 2.65, p < 0.00001) and timed up and go test (TUG, WMD, −0.59, p < 0.0001) demonstrated clinically relevant enhancements in KOA populations. Subgroup analyses revealed that multicomponent training (WMD, 6.25, p = 0.003), interventions lasting ≥ 8 weeks (WMD, 4.92, p = 0.002), sessions ≥ 60 min (WMD, 7.42, p = 0.002), frequency ≥ 3 times per week (WMD, 2.83, p = 0.0005), weekly time ≥ 180 min per week (WMD, 7.42, p = 0.002), and patients < 60 years (WMD, 6.71, p = 0.002) were associated with greater improvement in BBS. Conclusions: Exercise significantly improved balance function in KOA patients, with multicomponent training emerging as the most effective intervention. Based on the findings of this meta-analysis, clinicians should recommend that KOA patients engage in exercise at least three times per week, with each session lasting at least 60 min, to achieve a total weekly time of 180 min. These recommendations are particularly relevant for patients less than 60 years, who may experience greater benefits from exercise interventions.