Waller Benjamin, Ogonowska-Slodownik Anna, Vitor Manuel, Lambeck Johan, Daly Daniel, Kujala Urho M, Heinonen Ari
B. Waller, PT, MSc, Department of Health Sciences, University of Jyvaskyla, PO Box 35, FI-40014, Jyvaskyla, Finland.
A. Ogonowska-Slodownik, MSc, Faculty of Rehabilitation, Jozef Pilsudski University of Physical Education, Warsaw, Poland.
Phys Ther. 2014 Oct;94(10):1383-95. doi: 10.2522/ptj.20130417. Epub 2014 Jun 5.
Current management of osteoarthritis (OA) focuses on pain control and maintaining physical function through pharmacological, nonpharmacological, and surgical treatments. Exercise, including therapeutic aquatic exercise (TAE), is considered one of the most important management options. Nevertheless, there is no up-to-date systematic review describing the effect of TAE on symptoms and function associated with lower limb OA.
The purpose of this study was to conduct a systematic review with meta-analysis to determine the effect of TAE on symptoms and function associated with lower limb OA.
The data sources used in this study were: MEDLINE, PubMed, EMBASE, CINAHL, PEDro, and SPORTDiscus.
All studies selected for review were randomized controlled trials with an aquatic exercise group and a nontreatment control group. In total, 11 studies fulfilled the inclusion criteria and were included in the synthesis and meta-analysis.
Data were extracted and checked for accuracy by 3 independent reviewers.
Standardized mean difference (SMD) with 95% confidence interval (95% CI) was calculated for all outcomes. The meta-analysis showed a significant TAE effect on pain (SMD=0.26 [95% CI=0.11, 0.41]), self-reported function (SMD=0.30 [95% CI=0.18, 0.43]), and physical functioning (SMD=0.22 [95% CI=0.07, 0.38]). Additionally, a significant effect was seen on stiffness (SMD=0.20 [95% CI=0.03, 0.36]) and quality of life (SMD=0.24 [95% CI=0.04, 0.45]).
Heterogeneity of outcome measures and small sample sizes for many of the included trials imply that conclusions based on these results should be made with caution.
The results indicate that TAE is effective in managing symptoms associated with lower limb OA.
骨关节炎（OA）的当前管理重点是通过药物、非药物和手术治疗来控制疼痛并维持身体功能。运动，包括治疗性水中运动（TAE），被认为是最重要的管理选择之一。然而，目前尚无最新的系统评价描述TAE对下肢OA相关症状和功能的影响。
本研究的目的是进行一项系统评价并进行荟萃分析，以确定TAE对下肢OA相关症状和功能的影响。
本研究使用的数据来源包括：MEDLINE、PubMed、EMBASE、CINAHL、PEDro和SPORTDiscus。
所有入选进行综述的研究均为随机对照试验，设有水中运动组和非治疗对照组。共有11项研究符合纳入标准，并被纳入综合分析和荟萃分析。
由3名独立评审员提取数据并检查其准确性。
计算所有结局的标准化均数差（SMD）及其95%置信区间（95%CI）。荟萃分析显示TAE对疼痛（SMD=0.26[95%CI=0.11,0.41]）、自我报告的功能（SMD=0.30[95%CI=0.18,0.43]）和身体功能（SMD=0.22[95%CI=0.07,0.38]）有显著影响。此外，对僵硬（SMD=0.20[95%CI=0.03,0.36]）和生活质量（SMD=0.24[95%CI=0.04,0.45]）也有显著影响。
结局测量的异质性以及许多纳入试验的样本量较小，这意味着基于这些结果得出的结论应谨慎。
结果表明TAE对管理下肢OA相关症状有效。
