Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Melbourne, VIC, Australia.
Best Pract Res Clin Rheumatol. 2014 Feb;28(1):93-117. doi: 10.1016/j.berh.2014.01.009.
Exercise is recommended for the management of osteoarthritis (OA) in all clinical guidelines irrespective of disease severity, pain levels, and functional status. For knee OA, evidence supports the benefits of various types of exercise for improving pain and function in the short term. However, there is much less research investigating the effects of exercise in patients with OA at other joints such as the hip and hand. It is important to note that while the magnitude of exercise benefits may be considered small to moderate, these effects are comparable to reported estimates for simple analgesics and oral nonsteroidal anti-inflammatory drugs for OA pain but exercise has much fewer side effects. Exercise prescription should be individualized based on assessment findings and be patient centered involving shared decision making between the patient and clinician. Given that patient adherence to exercise declines over time, appropriate attention should be pain as reduced adherence attenuates the benefits of exercise. Given this, barriers and facilitators to exercise should be identified and strategies to maximize long-term adherence to exercise implemented.
运动被推荐用于管理骨关节炎（OA），所有临床指南无论疾病严重程度、疼痛水平和功能状态如何。对于膝骨关节炎，有证据支持各种类型的运动在短期内改善疼痛和功能的益处。然而，对于髋部和手部等其他关节 OA 患者的运动效果的研究要少得多。值得注意的是，虽然运动的益处幅度可能被认为是小到中度的，但这些效果与报道的 OA 疼痛的简单镇痛药和口服非甾体抗炎药的估计值相当，但运动的副作用要少得多。运动处方应根据评估结果个体化，并以患者为中心，让患者和临床医生共同做出决策。鉴于患者对运动的依从性随时间而下降，应适当关注疼痛，因为减少依从性会降低运动的益处。考虑到这一点，应确定运动的障碍和促进因素，并实施最大限度提高长期运动依从性的策略。
