Tanaka Ryo, Ozawa Junya, Kito Nobuhiro, Yamasaki Takahiro, Moriyama Hideki
Department of Integrated Rehabilitation, Hiroshima International University, Japan.
Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Japan.
J Jpn Phys Ther Assoc. 2013;16(1):7-21. doi: 10.1298/jjpta.Vol16_003.
To investigate improvement in various impairments by exercise interventions in patients with knee osteoarthritis (OA).
We collected data on randomized controlled trials (RCTs) comparing the effects of exercise intervention with those of either nonintervention or psychoeducational intervention in patients with knee OA. Data on pain, stiffness, muscle strength, range of motion, flexibility, maximal oxygen uptake, and position sense were synthesized. The Grading of Recommendations Assessment, Development, and Evaluation system was used to determine the quality of the evidence.
Thirty-three RCTs involving 3,192 participants were identified. Meta-analysis provided highquality evidence that exercise intervention improves maximal oxygen uptake, and moderate-quality evidence that exercise intervention also improves pain, stiffness, knee extensor and flexor muscle strength, and position sense. The evidence that exercise intervention improves knee extension and flexion range of motion was deemed as undetermined-quality.
In patients with knee OA, improvement in pain, stiffness, muscle strength, maximal oxygen uptake, and position sense with the use of exercise intervention can be expected. Although the quality of evidence of the effect of exercise intervention on range of motion was inconclusive, exercise intervention should be recommended for patients with knee OA to improve various impairments.
探讨运动干预对膝关节骨关节炎（OA）患者各种功能障碍的改善情况。
我们收集了关于随机对照试验（RCT）的数据，这些试验比较了运动干预与不干预或心理教育干预对膝关节OA患者的影响。综合了有关疼痛、僵硬、肌肉力量、活动范围、灵活性、最大摄氧量和位置觉的数据。采用推荐评估、制定与评价系统（GRADE）来确定证据的质量。
共纳入33项RCT，涉及3192名参与者。荟萃分析提供了高质量证据表明运动干预可改善最大摄氧量，以及中等质量证据表明运动干预还可改善疼痛、僵硬、膝关节伸肌和屈肌力量以及位置觉。运动干预改善膝关节屈伸活动范围的证据质量被判定为不确定。
对于膝关节OA患者，可预期运动干预能改善疼痛、僵硬、肌肉力量、最大摄氧量和位置觉。尽管运动干预对活动范围影响的证据质量尚无定论，但仍建议膝关节OA患者进行运动干预以改善各种功能障碍。
