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有多少髋和膝关节骨关节炎患者符合身体活动指南?系统评价和荟萃分析。

What proportion of people with hip and knee osteoarthritis meet physical activity guidelines? A systematic review and meta-analysis.

机构信息

Physiotherapy Department, Eastern Health, Australia; School of Allied Health, La Trobe University, Australia.

出版信息

Osteoarthritis Cartilage. 2013 Nov;21(11):1648-59. doi: 10.1016/j.joca.2013.08.003. Epub 2013 Aug 12.

Abstract

OBJECTIVE

To determine the proportion of people with hip and knee osteoarthritis that meet physical activity guidelines recommended for adults and older adults.

METHOD

Systematic review with meta-analysis of studies measuring physical activity of participants with hip and knee osteoarthritis using an activity monitor. Physical activity levels were calculated using the mean average [95% confidence interval (CI)] weighted according to sample size. Meta-analyses determined the proportion of people meeting physical activity guidelines and recommendations of (1) ≥150 min per week of moderate to vigorous physical activity (MVPA) in bouts of ≥10 min; (2) ≥150 min per week of MVPA in absence of bouts; (3) ≥10,000 steps per day and ≥7000 steps per day. The Grades of Research, Assessment, Development and Evaluation (GRADE) approach was used to determine the quality of the evidence.

RESULTS

For knee osteoarthritis, 21 studies involving 3266 participants averaged 50 min per week (95% CI = 46, 55) of MVPA when measured in bouts of ≥10 min, 131 min per week (95% CI = 125, 137) of MVPA, and 7753 daily steps (95% CI = 7582, 7924). Proportion meta-analyses provided high quality evidence that 13% (95% CI = 7, 20) completed ≥150 min per week of MVPA in bouts of ≥10 min, low quality evidence that 41% (95% CI = 23, 61) completed ≥150 min per week of MVPA in absence of bouts, moderate quality evidence that 19% (95% CI = 8, 33) completed ≥10,000 steps per day, and low quality evidence that 48% (95% CI = 31, 65) completed ≥7000 steps per day. For hip osteoarthritis, 11 studies involving 325 participants averaged 160 min per week (95% CI = 114, 216) of MVPA when measured in bouts of ≥10 min, 189 min per week (95% CI = 166, 212) of MVPA, and 8174 daily steps (95% CI = 7670, 8678). Proportion meta-analyses provided low quality evidence that 58% (95% CI = 18, 92) completed ≥150 min per week of MVPA in absence of bouts, low quality evidence that 30% (95% CI = 13, 50) completed ≥10,000 steps per day, and low quality evidence that 60% (95% CI = 47, 73) completed ≥7000 steps per day.

CONCLUSION

A small to moderate proportion of people with knee and hip osteoarthritis met physical activity guidelines and recommended daily steps. Future research should establish the effects of increasing physical activity in this population to meet the current physical activity guidelines.

摘要

目的

确定符合成年人和老年人推荐的身体活动指南的髋和膝关节骨关节炎患者的比例。

方法

系统评价和荟萃分析使用活动监测仪测量髋和膝关节骨关节炎患者身体活动的研究。使用根据样本量加权的平均平均[95%置信区间(CI)]计算身体活动水平。荟萃分析确定符合以下身体活动指南和建议的人群比例:(1)≥每周 150 分钟的中等到剧烈的身体活动(MVPA),每次≥10 分钟;(2)≥每周 150 分钟的 MVPA,无回合;(3)每天≥10000 步和每天≥7000 步。使用研究、评估、发展和评估等级(GRADE)方法来确定证据的质量。

结果

对于膝关节骨关节炎,21 项涉及 3266 名参与者的研究平均每周进行 50 分钟(95%CI=46,55)的 MVPA,当以≥10 分钟的回合测量时,每周进行 131 分钟的 MVPA(95%CI=125,137)和每天 7753 步(95%CI=7582,7924)。比例荟萃分析提供了高质量的证据,即 13%(95%CI=7,20)完成了每周≥150 分钟的 MVPA,有≥10 分钟的回合,低质量的证据表明 41%(95%CI=23,61)完成了每周≥150 分钟的 MVPA,无回合,中等质量的证据表明 19%(95%CI=8,33)完成了每天≥10000 步,低质量的证据表明 48%(95%CI=31,65)完成了每天≥7000 步。对于髋关节骨关节炎,11 项涉及 325 名参与者的研究平均每周进行 160 分钟(95%CI=114,216)的 MVPA,当以≥10 分钟的回合测量时,每周进行 189 分钟的 MVPA(95%CI=166,212)和每天 8174 步(95%CI=7670,8678)。比例荟萃分析提供了低质量的证据,即 58%(95%CI=18,92)完成了每周≥150 分钟的 MVPA,无回合,低质量的证据表明 30%(95%CI=13,50)完成了每天≥10000 步,低质量的证据表明 60%(95%CI=47,73)完成了每天≥7000 步。

结论

一小部分至中等比例的膝和髋关节炎患者符合身体活动指南和推荐的日常步数。未来的研究应该确定增加这一人群的身体活动量以达到当前身体活动指南的效果。

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