水上运动对膝骨关节炎的治疗效果是否优于陆上运动？

Is aquatic exercise more effective than land-based exercise for knee osteoarthritis?

作者信息

Dong Rui, Wu Yunyao, Xu Shibing, Zhang Lei, Ying Jun, Jin Hongting, Wang Pinger, Xiao Luwei, Tong Peijian

机构信息

The First Clinical Medical College of Zhejiang Chinese Medical University.

Institute of Orthopaedic and Traumatology, Zhejiang Province, Hangzhou, Zhejiang.

出版信息

Medicine (Baltimore). 2018 Dec;97(52):e13823. doi: 10.1097/MD.0000000000013823.

BACKGROUND

This study aimed to systemically review the effectiveness of aquatic exercise (AQE) compared to land-based exercise (LBE) in treating knee osteoarthritis (OA).

METHODS

The Medline, Embase, Web of Science, Cochrane Central Register of Controlled Clinical Trials, CINAHL, and psyclNFO databases were comprehensively searched for randomized controlled trials (RCTs) evaluating the effectiveness of AQE and LBE for knee OA from their inception date to September 24, 2018. The risk of bias was examined using the Cochrane Collaboration Tool, and Review Manager 5.3 was used for data collation and analysis.

RESULTS

Eight RCTs were included, involving a total of 579 patients. The meta-analysis showed that there was no significant difference between AQE and LBE for pain relief, physical function, and improvement in the quality of life, for both short- and long-term interventions, in patients with knee OA. However, the adherence and satisfaction level for AQE was higher than for LBE. Compared to no intervention, AQE showed a mild effect for elevating activities of daily living (standardized mean difference [SMD]: -0.55, 95% confidence interval [CI] [-0.94, -0.16], P = .005) and a high effect for improving sports and recreational activities (SMD: -1.03, 95% CI [-1.82, -0.25], P = .01).

CONCLUSION

AQE is comparable to LBE for treating knee OA.

背景

本研究旨在系统评价水上运动（AQE）与陆地运动（LBE）相比治疗膝骨关节炎（OA）的有效性。

方法

全面检索Medline、Embase、Web of Science、Cochrane临床对照试验中心注册库、CINAHL和psyclNFO数据库，以查找从起始日期至2018年9月24日评估AQE和LBE治疗膝骨关节炎有效性的随机对照试验（RCT）。使用Cochrane协作工具检查偏倚风险，并使用Review Manager 5.3进行数据整理和分析。

结果

纳入8项RCT，共涉及579例患者。荟萃分析表明，对于膝骨关节炎患者，无论是短期还是长期干预，AQE和LBE在缓解疼痛、身体功能和改善生活质量方面均无显著差异。然而，AQE的依从性和满意度水平高于LBE。与无干预相比，AQE在提高日常生活活动能力方面显示出轻度效果（标准化均值差[SMD]：-0.55，95%置信区间[CI][-0.94，-0.16]，P = 0.005），在改善运动和娱乐活动方面显示出高度效果（SMD：-1.03，95%CI[-1.82，-0.25]，P = 0.01）。