Bricca A, Juhl C B, Grodzinsky A J, Roos E M
University of Southern Denmark, Odense, Denmark.
University of Southern Denmark, Odense, Denmark; Department of Rehabilitation, University of Copenhagen, Herlev and Gentofte Hospital, Copenhagen, Denmark.
Osteoarthritis Cartilage. 2017 Aug;25(8):1223-1237. doi: 10.1016/j.joca.2017.03.009. Epub 2017 Mar 18.
To investigate the impact of a daily exercise dose on cartilage composition and thickness, by conducting a systematic review of randomized controlled trials (RCTs) involving healthy animals.
A narrative synthesis of the effect of a daily exercise dose on knee cartilage aggrecan, collagen and thickness was performed. A subset of studies reporting sufficient data was combined in meta-analysis using a random-effects model. Meta-regression analyses were performed to investigate the impact of covariates.
Twenty-nine RCTs, involving 64 comparisons, were included. In the low dose exercise group, 21/25 comparisons reported decreased or no effect on cartilage aggrecan, collagen and thickness. In the moderate dose exercise group, all 12 comparisons reported either no or increased effect. In the high dose exercise group, 19/27 comparisons reported decreased effect. A meta-analysis of 14 studies investigating cartilage thickness showed no effect in the low dose exercise group (SMD -0.02; 95% CI -0.42 to 0.38; I = 0.0%), large but non-significant cartilage thickening in the moderate dose exercise group (SMD 0.95; 95% CI -0.33 to 2.23; I = 72.1%) and non-significant cartilage thinning in the high dose exercise group (SMD -0.19; 95% CI -0.49 to 0.12; I = 0.0%). Results were independent of analyzed covariates. The overall quality of the studies was poor because of inadequate reporting of data and high risk of bias.
Our results suggest that the relationship between daily exercise dose and cartilage composition, but not necessarily cartilage thickness, may be non-linear. While we found inconclusive evidence for a low daily dose of exercise, a high daily dose of exercise may have negative effects and a moderate daily dose of exercise may have positive effects on cartilage matrix composition in healthy animals.
通过对涉及健康动物的随机对照试验（RCT）进行系统评价，研究每日运动剂量对软骨成分和厚度的影响。
对每日运动剂量对膝关节软骨聚集蛋白聚糖、胶原蛋白和厚度的影响进行叙述性综合分析。对报告了足够数据的一部分研究，使用随机效应模型进行荟萃分析。进行荟萃回归分析以研究协变量的影响。
纳入了29项RCT，涉及64项比较。在低剂量运动组中，25项比较中有21项报告对软骨聚集蛋白聚糖、胶原蛋白和厚度有降低或无影响。在中等剂量运动组中，所有12项比较均报告无影响或有增加的影响。在高剂量运动组中，27项比较中有19项报告有降低的影响。对14项研究软骨厚度的荟萃分析显示，低剂量运动组无影响（标准化均数差[SMD] -0.02；95%可信区间[-0.42至0.38]；I² = 0.0%），中等剂量运动组有较大但无统计学意义的软骨增厚（SMD 0.95；95%可信区间[-0.33至2.23]；I² = 72.1%），高剂量运动组有非统计学意义的软骨变薄（SMD -0.19；95%可信区间[-0.49至0.12]；I² = 0.0%）。结果与分析的协变量无关。由于数据报告不充分和偏倚风险高，研究的总体质量较差。
我们的结果表明，每日运动剂量与软骨成分之间的关系可能是非线性的，但不一定与软骨厚度有关。虽然我们发现低剂量每日运动的证据不明确，但高剂量每日运动可能有负面影响，而中等剂量每日运动可能对健康动物的软骨基质成分有积极影响。
