Fernandopulle Shanelle, Perry Meredith, Manlapaz Donald, Jayakaran Prasath
From the Centre for Health, Activity and, Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin (SF, DM, PJ); Wellington Hospital, Capital and Coast District Health Board, Wellington (SF); and Centre for Health, Activity and, Rehabilitation Research, School of Physiotherapy, University of Otago, Wellington (MP), New Zealand.
Am J Phys Med Rehabil. 2017 Nov;96(11):773-792. doi: 10.1097/PHM.0000000000000736.
The aim of this study was to evaluate the effects of land-based generic physical activity interventions on pain, physical function, and physical performance in individuals with hip/knee osteoarthritis, when compared with a control group that received no intervention, minimal intervention, or usual care.
A systematic search for randomized controlled trials on 11 electronic databases (from their inception up until April 30, 2016) identified 27 relevant articles. According to the compendium of physical activities, interventions were categorized into: recreational activities (tai chi/Baduajin-6 articles), walking (9 articles), and conditioning exercise (12 articles).
Meta-analysis for recreational activity (n = 3) demonstrated significant mean difference (MD) of -9.56 (95% confidence interval [CI], -13.95 to -5.17) for physical function (Western Ontario and McMaster Universities Arthritis Index) at 3 mos from randomization. Pooled estimate for walking intervention was not significant for pain intensity and physical performance but was significant for physical function (n = 2) with a MD of -10.38 (95% CI, -12.27 to -8.48) at 6 mos. Meta-analysis for conditioning exercise was significant for physical function (n = 3) with a MD of -3.74 (95% CI, -5.70 to -1.78) and physical performance (6-minute walk test) with a MD of 42.72 m (95% CI, 27.78, 57.66) at 6 mos. The timed stair-climbing test (n = 2) demonstrated a significant effect at 18 mos with a MD of -0.49 secs (95% CI, -0.75 to -0.23).
Very limited evidence to support recreational activity and walking intervention was found for knee osteoarthritis, in the short-term on pain and physical function, respectively.
本研究旨在评估与未接受干预、接受极少干预或常规护理的对照组相比，陆上一般体育活动干预对髋/膝骨关节炎患者疼痛、身体功能和身体表现的影响。
在11个电子数据库（从建库至2016年4月30日）中系统检索随机对照试验，共识别出27篇相关文章。根据体育活动纲要，干预措施分为：娱乐活动（太极拳/八段锦 - 6篇文章）、步行（9篇文章）和体能锻炼（12篇文章）。
对娱乐活动（n = 3）的荟萃分析显示，随机分组后3个月时，身体功能（西安大略和麦克马斯特大学骨关节炎指数）的平均差异（MD）为 -9.56（95%置信区间[CI]，-13.95至 -5.17）。步行干预的合并估计在疼痛强度和身体表现方面无显著差异，但在6个月时身体功能方面有显著差异（n = 2），MD为 -10.38（95%CI，-12.27至 -8.48）。体能锻炼的荟萃分析在6个月时身体功能方面有显著差异（n = 3），MD为 -3.74（95%CI，-5.70至 -1.78），在身体表现（6分钟步行试验）方面有显著差异，MD为42.72米（95%CI，27.78，57.66）。定时爬楼梯试验（n = 2）在18个月时显示有显著效果，MD为 -0.49秒（95%CI，-0.75至 -0.23）。
对于膝骨关节炎，在短期内分别针对疼痛和身体功能，支持娱乐活动和步行干预的证据非常有限。
