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. 2022 Oct 3;13:934511. doi: 10.3389/fphys.2022.934511

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Copyright © 2022 Guo, Zhao, Zhou, Wang and Wang.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Forest plot of comparison: high versus uncertain, outcome: 1.3 Stiffness (WOMAC). Effect of land-based exercise compared to control when stiffness outcomes were assessed using the WOMAC stiffness subscale. Data are presented as standardized mean differences, with differences <0 favoring land-based exercise. Subgroup analysis showed that the high-compliance group [SMD −0.40 (95% CI −0.61, −0.19), I² = 0%] (p < 0.001) showed significant improvement in stiffness measures and the uncertain-compliance group [SMD −0.29 (95% CI −0.66, 0.07), I² = 27%] (p = 0.120) did not. Subgroup analysis showed similar effects for pain in the high-compliance group [SMD −0.21 (95% CI −0.38, −0.05), I² = 0%] (p = 0.010) and those with the uncertain-compliance group [SMD −0.61 (95% CI −0.82, −0.40), I² = 49%] (p < 0.001).