Research Unit for Musculoskeletal Function, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Osteoarthritis Cartilage. 2012 Dec;20(12):1477-83. doi: 10.1016/j.joca.2012.08.028. Epub 2012 Sep 7.
UNLABELLED: Recent scientific advances in the treatment of hip and knee osteoarthritis (OA) relating to education, exercise, weight control and passive non-pharmacological and non-surgical treatments such as manual therapy, orthoses/orthotics and other aids are described. METHODS: A systematic literature search was performed in Medline from July 2011 to 10 April 2012 using the terms 'osteoarthritis, knee', 'osteoarthritis, hip' rehabilitation, physical therapy, exercise therapy and preoperative intervention; both as text words and as MeSH terms where possible. Trials evaluating rehabilitation interventions were included if they were randomized controlled trials (RCTs) or systematic reviews. Outcome papers were identified by combining the initial search with the terms 'outcome', 'measure*', 'valid*', 'reliabil*' or 'responsiveness'. Outcome studies were included if they contributed methodologically to advancing outcome measurement. RESULTS: The literature search identified 550 potentially relevant papers. Seventeen RCTs on rehabilitation were selected and the results from these were supported by six systematic reviews. Sixteen outcomes papers were considered relevant, but did not add significantly to current knowledge about outcome measures in OA and so, were not included. CONCLUSION: The current research focus on non-pharmacological and non-surgical treatments for hip and/or knee OA, when combined in systematic reviews, is improving the available evidence to identify best practice treatment. Education, exercise and weight loss are effective in the long term and supported as cost-effective first-line treatments.
未加标签:本文描述了在髋关节和膝关节骨关节炎(OA)治疗方面的最新科学进展,涉及教育、锻炼、体重控制以及被动的非药物和非手术治疗,如手法治疗、矫形器/矫形术和其他辅助器具。
方法:我们在 Medline 上进行了系统的文献检索,检索时间为 2011 年 7 月至 2012 年 4 月 10 日,使用的检索词包括“骨关节炎,膝关节”“骨关节炎,髋关节”“康复”“物理疗法”“运动疗法”和“术前干预”;这些词既可以作为文本词,也可以作为 MeSH 术语。如果评估康复干预的试验是随机对照试验(RCT)或系统评价,则将其纳入研究。通过将初始搜索与“结果”“测量”“有效性”“可靠性”或“反应性”等术语相结合,确定结果研究。如果结果研究在推进结果测量方法方面具有重要意义,则将其纳入研究。
结果:文献检索确定了 550 篇潜在相关的论文。选择了 17 项关于康复的 RCT,并对这些 RCT 的结果进行了 6 项系统评价的支持。有 16 篇结果论文被认为是相关的,但并没有显著增加关于 OA 结果测量的现有知识,因此没有纳入研究。
结论:目前的研究重点是非药物和非手术治疗髋关节和/或膝关节 OA,当这些研究被综合在系统评价中时,正在改善现有证据,以确定最佳实践治疗方法。教育、锻炼和减肥在长期内是有效的,并被支持作为具有成本效益的一线治疗方法。
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