Pisters Martijn F, Veenhof Cindy, van Meeteren Nico L U, Ostelo Raymond W, de Bakker Dinny H, Schellevis François G, Dekker Joost
Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
Arthritis Rheum. 2007 Oct 15;57(7):1245-53. doi: 10.1002/art.23009.
To determine the long-term effectiveness (>/=6 months after treatment) of exercise therapy on pain, physical function, and patient global assessment of effectiveness in patients with osteoarthritis (OA) of the hip and/or knee.
We conducted an extensive literature search in PubMed, EMBase, CINAHL, SciSearch, PEDro, and the Cochrane Central Register of Controlled Trials. Both randomized clinical trials and controlled clinical trials on the long-term effectiveness of exercise therapy were included. The followup assessments were at least 6 months after treatment ended. Methodologic quality was independently assessed by 2 reviewers. Effect estimates were calculated and a best evidence synthesis was performed based on design, methodologic quality, and statistical significance of findings.
Five high-quality and 6 low-quality randomized clinical trials were included. Strong evidence was found for no long-term effectiveness on pain and self-reported physical function, moderate evidence for long-term effectiveness on patient global assessment of effectiveness, and conflicting evidence for observed physical function. For exercise programs with additional booster sessions, moderate evidence was found for long-term effectiveness on pain, self-reported physical function, and observed physical function.
The positive posttreatment effects of exercise therapy on pain and physical function in patients with OA of the hip and/or knee are not sustained in the long term. Long-term effectiveness was only found for patient global assessment of effectiveness. However, additional booster sessions after the treatment period positively influenced maintenance of beneficial posttreatment effects on pain and physical function in the long term.
确定运动疗法对髋和/或膝骨关节炎（OA）患者疼痛、身体功能及患者整体疗效评估的长期有效性（治疗后≥6个月）。
我们在PubMed、EMBase、CINAHL、SciSearch、PEDro以及Cochrane对照试验中央注册库中进行了广泛的文献检索。纳入了关于运动疗法长期有效性的随机临床试验和对照临床试验。随访评估在治疗结束后至少6个月进行。方法学质量由2名评审员独立评估。计算效应估计值，并基于研究设计、方法学质量和结果的统计学显著性进行最佳证据综合分析。
纳入了5项高质量和6项低质量的随机临床试验。有强有力的证据表明运动疗法对疼痛和自我报告的身体功能无长期有效性，有中等证据表明对患者整体疗效评估有长期有效性，而关于观察到的身体功能则存在相互矛盾的证据。对于有额外强化训练课程的运动项目，有中等证据表明对疼痛、自我报告的身体功能和观察到的身体功能有长期有效性。
运动疗法对髋和/或膝OA患者疼痛和身体功能的治疗后积极效果在长期内无法持续。仅在患者整体疗效评估方面发现了长期有效性。然而，治疗期后的额外强化训练课程对长期维持治疗后对疼痛和身体功能的有益效果有积极影响。
