Susko Allyn M, Fitzgerald G Kelley
Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA.
Open Access Rheumatol. 2013 Oct 15;5:81-91. doi: 10.2147/OARRR.S53974. eCollection 2013.
The purpose of this review article is to explore the role of therapeutic exercise in managing the pain associated with knee osteoarthritis (OA). Therapeutic exercise is often recommended as a first-line conservative treatment for knee OA, and current evidence supports exercise as an effective pain-relieving intervention. We explore the current state of evidence for exercise as a pain-relieving intervention for knee OA. Next, the mechanisms by which knee OA pain occurs and the potential ways in which exercise may act on those mechanisms are discussed. Clinical applicability and future research directions are suggested. Although evidence demonstrates that exercise reduces knee OA pain, optimal exercise mode and dosage have not been determined. In addition, it is not clearly understood whether exercise provides pain relief via peripheral or central mechanisms or a combination of both. Published clinical trials have explored a variety of interventions, but these interventions have not been specifically designed to target pain pathways. Current evidence strongly supports exercise as a pain-relieving option for those with knee OA. Future research needs to illuminate the mechanisms by which exercise reduces the pain associated with knee OA and the development of therapeutic exercise interventions to specifically target these mechanisms.
这篇综述文章的目的是探讨治疗性运动在管理与膝关节骨关节炎（OA）相关疼痛方面的作用。治疗性运动通常被推荐为膝关节OA的一线保守治疗方法，目前的证据支持运动作为一种有效的止痛干预措施。我们探讨了运动作为膝关节OA止痛干预措施的现有证据状况。接下来，讨论了膝关节OA疼痛发生的机制以及运动可能作用于这些机制的潜在方式。提出了临床适用性和未来研究方向。尽管有证据表明运动可减轻膝关节OA疼痛，但最佳运动方式和剂量尚未确定。此外，目前尚不清楚运动是通过外周机制还是中枢机制或两者结合来缓解疼痛。已发表的临床试验探索了多种干预措施，但这些干预措施并非专门针对疼痛途径设计。目前的证据有力地支持运动作为膝关节OA患者的一种止痛选择。未来的研究需要阐明运动减轻膝关节OA相关疼痛的机制，以及开发专门针对这些机制的治疗性运动干预措施。
