Aging Clinical and Experimental Research · Jan 4, 2026

Swedish massage versus hip strengthening exercises for pain and function in older adults with knee osteoarthritis: a randomized controlled trial

By Asgarimoghadam A, Ravari A, Mirzaei T et al.

BACKGROUND: Knee osteoarthritis (KOA) is a progressive disease that impairs mobility and quality of life in older adults. AIMS: To compare the effects of Swedish massage (SM) and hip strengthening exercises (HSE) versus control on pain, range of motion (ROM), and function in older adults with KOA. METHODS: Seventy-five adults > 60 years with symptomatic KOA were randomized to SM, HSE, or control for 8 weeks of home-based intervention (3 sessions/week, 30 min each). Outcomes included pain, function, and ROM at baseline and week 8. Intention-to-treat analysis used ANCOVA adjusted for baseline values, with Bonferroni correction for two pre-specified comparisons (α = 0.025). RESULTS: Seventy participants completed the study (93.3%); adherence exceeded 85%. No serious adverse events occurred. Both active interventions significantly outperformed control across all outcomes. Compared with control, SM reduced VAS pain by an adjusted mean of 0.81 cm (95% CI 0.38–1.24, p < 0.001, d = 0.69) and HSE by 0.77 cm (95% CI 0.34–1.20, p < 0.001, d = 0.65). KOOS-ADL improved by 3.59 points with SM (95% CI 1.62–5.56, p < 0.001, d = 0.71) and 3.40 points with HSE (95% CI 1.43–5.37, p = 0.001, d = 0.67). Active knee flexion ROM increased by 3.42° (SM, p = 0.001, d = 0.73) and 3.69° (HSE, p < 0.001, d = 0.77) vs. control. DISCUSSION: This study shows SM and HSE as safe, feasible home-based options for pain relief in frail older adults with KOA. CONCLUSIONS: SM and HSE mitigate KOA pain, with SM uniquely enhancing daily function, supporting integration into clinical practice to promote independence and reduce healthcare burdens in aging populations. CLINICAL TRIAL REGISTRATION: IRCT20150519022320N33 (August 12, 2023).

doi.org/10.1007/s40520-025-03313-z Open access PubMed 41485179 Interventions