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2017 年骨关节炎年度回顾:康复与结局。

Osteoarthritis year in review 2017: rehabilitation and outcomes.

机构信息

Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands.

出版信息

Osteoarthritis Cartilage. 2018 Mar;26(3):326-340. doi: 10.1016/j.joca.2018.01.006. Epub 2018 Jan 9.

Abstract

OBJECTIVE

The purpose of this systematic review was to describe studies examining rehabilitation for people with osteoarthritis (OA) and to summarize findings from selected key systematic reviews (SRs) and randomized controlled trials (RCTs).

DESIGN

A systematic search was performed using Pubmed, Embase and Cochrane databases from April 1 2016 to May 15 2017 using the terms 'osteoarthritis', 'randomized controlled trial', and 'systematic review'. Inclusion criteria were: clinically or radiologically diagnosed patients with OA, rehabilitation treatment, RCT or SRs. A selection of the included studies is discussed based on study quality and perceived importance to the field; including those that are innovative, inform the direction of the field or generate controversy. Methodological quality of the included studies was assessed using the PEDro-scale for RCTs and the Amstar guideline for SRs.

RESULTS

From 1211 articles, 80 articles met the eligibility criteria including 21 SRs and 61 RCTs. The median of the methodological quality of the SRs and RCTs was 7 (2-9) and 6 (3-10), respectively. The studies were grouped into several themes, covering the most important rehabilitation fields.

CONCLUSIONS

Striking is the small number of studies investigating another joint (18%) than the knee (82%). Exercise is the most common treatment evaluated and should be accompanied with education to effectuate a behavioural change in physical activity of people with OA. No new insights in the field of braces (or orthoses) and in the field of acupuncture were found.

摘要

目的

本系统评价旨在描述针对骨关节炎(OA)患者的康复研究,并总结部分重点系统评价(SR)和随机对照试验(RCT)的研究结果。

设计

本系统检索使用了 Pubmed、Embase 和 Cochrane 数据库,检索时间为 2016 年 4 月 1 日至 2017 年 5 月 15 日,检索词为“osteoarthritis”、“randomized controlled trial”和“systematic review”。纳入标准为:临床或影像学诊断为 OA 的患者,康复治疗,RCT 或 SR。根据研究质量和对该领域的重要性选择部分纳入研究进行讨论;包括那些具有创新性、指导该领域发展或引起争议的研究。纳入研究的方法学质量使用 RCT 的 PEDro 量表和 SR 的 Amstar 指南进行评估。

结果

从 1211 篇文章中,有 80 篇文章符合纳入标准,包括 21 篇 SR 和 61 篇 RCT。SR 和 RCT 的方法学质量中位数分别为 7(2-9)和 6(3-10)。研究分为几个主题,涵盖了最重要的康复领域。

结论

令人惊讶的是,研究膝关节以外其他关节(18%)的研究数量较少(82%)。运动是评估的最常见治疗方法,应该结合教育,以改变 OA 患者的身体活动行为。在支具(或矫形器)和针灸领域没有新的发现。

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