National Advisory Unit for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Pb 23 Vinderen, 0319 Oslo, Norway.
Osteoarthritis Cartilage. 2017 Oct;25(10):1563-1576. doi: 10.1016/j.joca.2017.06.004. Epub 2017 Jun 23.
To compare effects of land-based exercise programmes with high vs low or uncertain compliance with dose recommendations among people with hip osteoarthritis (OA).
A systematic review with meta-analyses of supervised exercise programmes in people with symptomatic hip OA was conducted. Dose of the exercise interventions was evaluated according to the American College of Sports Medicine's (ACSM) recommendations for developing and maintaining cardiorespiratory fitness, muscular strength and flexibility in healthy adults. Compliance ratios with the recommendations were calculated. Standardized Mean Differences (SMDs) were calculated in meta-analyses for the outcomes pain and self-reported physical function. Outcome effects were compared between the sub-groups of studies with interventions with "high" vs "uncertain" compliance with the ACSM recommendations.
Twelve studies including 1202 participants were included. Seven were categorized with "high" and five with "uncertain" compliance with the ACSM recommendations. Ten studies had an overall low risk of bias. Comparing exercise with no exercise, the pooled SMD for pain was -0.42 (95% CI -0.58, -0.26) in the high compliance group, favouring exercise. In the uncertain compliance group the pooled SMD was 0.04 (95% CI -0.24, 0.31). For physical function the SMD was -0.41 (95% CI -0.58, -0.24) in the high compliance group and -0.23 (95% CI -0.52, 0.06) in the uncertain compliance group.
The results show that land-based supervised exercise interventions with high compliance to the ACSM recommendations result in significantly larger improvements in pain and non-significantly larger improvement in self-reported physical function compared with land-based supervised exercise interventions with uncertain compliance.
比较基于陆地的运动方案在符合与不符合美国运动医学学院（ACSM）剂量建议的情况下对髋骨关节炎（OA）患者的影响。
对有症状髋 OA 患者的监督运动方案进行了系统评价和荟萃分析。根据 ACSM 为健康成年人制定的发展和保持心肺健康、肌肉力量和柔韧性的建议，评估运动干预的剂量。计算了对建议的依从比例。在荟萃分析中，计算了疼痛和自我报告的身体功能这两个结局的标准化均数差（SMD）。比较了具有“高”和“不确定”ACS 建议依从性的亚组研究中干预措施的结果效果。
纳入了 12 项研究，共 1202 名参与者。其中 7 项研究归类为“高”和 5 项研究归类为“不确定”符合 ACSM 建议。有 10 项研究整体的偏倚风险较低。与不运动相比，高依从性组的疼痛 pooled SMD 为-0.42（95%CI-0.58，-0.26），运动更有利。在不确定依从性组，pooled SMD 为 0.04（95%CI-0.24，0.31）。对于身体功能，高依从性组的 SMD 为-0.41（95%CI-0.58，-0.24），不确定依从性组的 SMD 为-0.23（95%CI-0.52，0.06）。
结果表明，与不确定符合 ACSM 建议的基于陆地的监督运动干预相比，高依从性的基于陆地的监督运动干预可显著改善疼痛，且非显著改善自我报告的身体功能。
