Lu Meili, Su Youxin, Zhang Yingjie, Zhang Ziyi, Wang Wenting, He Zhen, Liu Feiwen, Li Yanan, Liu Changyan, Wang Yiru, Sheng Lu, Zhan Zhengxuan, Wang Xu, Zheng Naixi
Fujian University of Traditional Chinese Medicine, No.1 Qiuyang St., Shangjie, Minhou, Fuzhou, Fujian, China.
Z Rheumatol. 2015 Aug;74(6):543-52. doi: 10.1007/s00393-014-1559-9.
OBJECTIVE: This paper presents a systematic review and meta-analysis of the effectiveness of aquatic exercise for treatment of knee osteoarthritis (OA). METHODS: PubMed, the Cochrane Library, Embase, CAMbase, and the Web of Science were screened through to June 2014. Only randomized controlled trials (RCTs) comparing aquatic exercise with control conditions were included. Two authors independently selected trials for inclusion, assessed the included trials, and extracted data. Outcome measures included pain, physical function, joint stiffness, quality of life (QOL), and safety. Pooled outcomes were analyzed using standardized mean difference (SMD). RESULTS: There is a lack of high quality studies in this area. Six RCTs (398 participants) were included. There was moderate evidence for a moderate effect on physical function in favor of aquatic exercise immediately after the intervention, but no evidence for pain or QOL when comparing aquatic exercise with nonexercise. Only one trial reported 3 months of follow-up measurements, which demonstrated limited evidence for pain improvement with aquatic exercise and no evidence for QOL or physical function when comparing aquatic exercise with nonexercise. There was limited evidence for pain improvement with land-based exercise and no evidence for QOL or physical function, when comparing aquatic exercise with land-based exercise according to follow-up measurements. No evidence was found for pain, physical function, stiffness, QOL, or mental health with aquatic exercise immediately after the intervention when comparing aquatic exercise with land-based exercise. Two studies reported aquatic exercise was not associated with serious adverse events. CONCLUSION: Aquatic exercise appears to have considerable short-term benefits compared with land-based exercise and nonexercise in patients with knee OA. Based on these results, aquatic exercise is effective and safe and can be considered as an adjuvant treatment for patients with knee OA. Studies in this area are still too scarce and too short-term to provide further recommendations on how to apply this therapy.
目的：本文对水上运动治疗膝骨关节炎（OA）的有效性进行系统评价和荟萃分析。 方法：检索至2014年6月的PubMed、Cochrane图书馆、Embase、CAMbase和科学引文索引。仅纳入比较水上运动与对照条件的随机对照试验（RCT）。两名作者独立选择纳入试验、评估纳入试验并提取数据。结局指标包括疼痛、身体功能、关节僵硬、生活质量（QOL）和安全性。采用标准化均数差（SMD）分析合并结局。 结果：该领域缺乏高质量研究。纳入6项RCT（398名参与者）。有中等证据表明干预后立即进行水上运动对身体功能有中等程度的改善，但与非运动相比，在疼痛或生活质量方面没有证据支持。仅有一项试验报告了3个月的随访测量结果，显示水上运动改善疼痛的证据有限，与非运动相比，在生活质量或身体功能方面没有证据支持。根据随访测量结果，与陆上运动相比，水上运动改善疼痛的证据有限，在生活质量或身体功能方面没有证据支持。干预后立即将水上运动与陆上运动进行比较时，在疼痛、身体功能、僵硬、生活质量或心理健康方面没有发现水上运动的证据。两项研究报告水上运动与严重不良事件无关。 结论：与陆上运动和非运动相比，水上运动在膝骨关节炎患者中似乎有相当大的短期益处。基于这些结果，水上运动是有效且安全的，可被视为膝骨关节炎患者的辅助治疗方法。该领域的研究仍然太少且短期，无法就如何应用这种疗法提供进一步建议。
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