Meta-Analysis of the Effectiveness of Physiotherapy-Based Exercise Interventions in Individuals with Knee Osteoarthritis: A Systematic Review

Background: Knee osteoarthritis (OA) is one of the major causes of disability globally, for which exercise therapy is established as a cornerstone of conservative management, the heterogeneity in intervention design and delivery limits the therapists to generalize the findings. Objective: To do systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating physiotherapy-based exercise interventions for knee OA without any categorization. Methods: Electronic databases such as PubMed, Scopus and Web of Science were searched for RCTs published between 2000 and 2025. Eligible studies investigated supervised physiotherapy exercise protocols targeting pain, function, and quality of life. The tool used was the Cochrane Risk of Bias 2.0 and the standard mean differences (SMDs) were combined via a random-effects model. Results: Out of 334 records, three studies (n = 260) met inclusion criteria. Interventions included quadriceps/hip strengthening, dynamic balance training, and resistance exercise. Combined meta-analysis has revealed significant improvement in pain reduction (SMD = 0.35, 95% CI: 0.10–0.60, p = 0.006, I² = 40%) and functional outcomes (SMD = 0.41, 95% CI: 0.17–0.65, p < 0.01, I² = 55%) which favours exercise therapy. Conclusion: Physiotherapy exercises play an important role in reducing pain and improving daily function for people living with knee osteoarthritis. Many studies show that targeted programs can lead to significant improvements in mobility, strength, and quality of life. Looking ahead, researchers should continue to refine exercise plans by exploring the best dosage, approaches for boosting patient adherence, and protocols tailored to diverse groups and individual needs. Keywords: Knee Osteoarthritis, Physiotherapy, Exercise Therapy, Pain, Function, Systematic Review, Meta-Analysis