School of Science and Technology, Laboratory of Biomechanics and Motor Control (LABCOM), São Paulo State University, Presidente Prudente, Brazil.
Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.
Br J Sports Med. 2018 Aug;52(16):1031-1038. doi: 10.1136/bjsports-2017-098099. Epub 2018 Mar 16.
To systematically review evidence of primary outcomes from randomised controlled trials (RCTs) examining the effect of treatment strategies on quality of life (QoL) or psychosocial factors in individuals with knee osteoarthritis (OA).
Systematic review with meta-analysis.
Medline, Embase, SPORTDiscus, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Web of Science were searched from inception to November 2017.
We included RCTs investigating the effect of conservative interventions on QoL or psychosocial factors in individuals with knee OA. Only RCTs considering these outcomes as primary were included.
Pooled data supported the use of exercise therapy compared with controls for improving health-related and knee-related QoL. There was limited evidence that a combined treatment of yoga, transcutaneous electrical stimulation and ultrasound may be effective in improving QoL. Limited evidence supported the use of cognitive behavioural therapies (with or without being combined with exercise therapy) for improving psychosocial factors such as self-efficacy, depression and psychological distress.
SUMMARY/CONCLUSION: Exercise therapy (with or without being combined with other interventions) seems to be effective in improving health-related and knee-related QoL or psychosocial factors of individuals with knee OA. In addition, evidence supports the use of cognitive behavioural therapies (with or without exercise therapy) for improving psychosocial factors such as self-efficacy, depression and psychological distress in individuals with knee OA.
CRD42016047602.
系统评价随机对照试验（RCT）中关于治疗策略对膝骨关节炎（OA）患者生活质量（QoL）或心理社会因素影响的主要结局指标的证据。
系统评价和荟萃分析。
从建库到 2017 年 11 月，检索了 Medline、Embase、SPORTDiscus、护理学及相关健康专业文献累积索引（CINAHL）和 Web of Science。
纳入研究为调查保守治疗对膝 OA 患者 QoL 或心理社会因素影响的 RCT，仅纳入将这些结局作为主要结局的 RCT。
汇总数据支持与对照组相比，运动疗法可改善健康相关和膝关节相关 QoL。瑜伽、经皮电刺激和超声联合治疗可能有效改善 QoL 的证据有限。有限的证据支持认知行为疗法（与或不与运动疗法联合使用）用于改善自我效能、抑郁和心理困扰等心理社会因素。
运动疗法（单独或联合其他干预）似乎可有效改善膝骨关节炎患者的健康相关和膝关节相关 QoL 或心理社会因素。此外，证据支持认知行为疗法（与或不与运动疗法联合使用）用于改善膝骨关节炎患者的自我效能、抑郁和心理困扰等心理社会因素。
PROSPERO 注册号：CRD42016047602。
