Herlev and Gentofte Hospitals, University of Copenhagen, Copenhagen, Denmark.
Lund University, Lund, Sweden.
Arthritis Care Res (Hoboken). 2019 Nov;71(11):1504-1515. doi: 10.1002/acr.23786.
To investigate the impact of exercise therapy on molecular biomarkers related to cartilage and inflammation in individuals at risk of, or with established, knee osteoarthritis by conducting a systematic review of randomized controlled trials (RCTs).
We conducted a literature search up to September 2017 in 5 major databases with no restriction on publication year or language. Data were extracted from the first available follow-up time point, and we performed a narrative synthesis for the effect of exercise therapy on molecular biomarkers related to cartilage and inflammation. A subset of studies reporting sufficient data was combined in a meta-analysis, using an adjusted random-effects model.
Twelve RCTs involving 57 study comparisons at 4 to 24 weeks following an exercise-therapy intervention were included. Exercise therapy decreased molecular biomarkers in 17 study comparisons (30%), had no effect in 36 (63%), and increased molecular biomarkers in 4 study comparisons (7%). Meta-analyses of 9 biomarkers showed that exercise therapy was associated with nonsignificant reductions of the C-reactive protein level, C-terminal crosslinking telopeptide of type II collagen, tumor necrosis factor (TNF), soluble TNF receptors 1 and 2, C2C neoepitope of type II collagen, and cartilage oligomeric matrix protein, compared to nonexercising control groups, and exercise therapy had no effect on interleukin-6 and soluble interleukin-6 receptor.
Exercise therapy is not harmful, because it does not increase the concentration of molecular biomarkers related to cartilage turnover and inflammation, implicated in osteoarthritis progression. The overall quality of evidence was downgraded to low because of the limited number of RCTs available.
通过系统综述随机对照试验（RCT），研究运动疗法对处于骨关节炎风险中或已确诊的个体的软骨和炎症相关分子生物标志物的影响。
我们对 5 个主要数据库进行了文献检索，检索时间截至 2017 年 9 月，对发表年份和语言不设限制。从最早可获得的随访时间点提取数据，对运动疗法对软骨和炎症相关分子生物标志物的影响进行叙述性综合分析。对有足够数据报告的一部分研究进行荟萃分析，采用调整后的随机效应模型。
纳入了 12 项 RCT，涉及 4 至 24 周运动疗法干预后的 57 项研究比较。17 项研究比较（30%）显示运动疗法降低了分子生物标志物，36 项研究比较（63%）没有影响，4 项研究比较（7%）增加了分子生物标志物。对 9 项生物标志物的荟萃分析显示，与非运动对照组相比，运动疗法与 C 反应蛋白水平、Ⅱ型胶原 C 末端交联肽、肿瘤坏死因子（TNF）、可溶性 TNF 受体 1 和 2、Ⅱ型胶原 C2C 新表位和软骨寡聚基质蛋白的非显著降低相关，运动疗法对白细胞介素-6 和可溶性白细胞介素-6 受体没有影响。
运动疗法不会造成伤害，因为它不会增加与软骨更新和炎症相关的、与骨关节炎进展有关的分子生物标志物的浓度。由于现有的 RCT 数量有限，总体证据质量被降级为低。
