Duke Molecular Physiology Institute, Department of Medicine, Duke University School of Medicine, Durham, NC.
National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD.
Med Sci Sports Exerc. 2019 Jun;51(6):1324-1339. doi: 10.1249/MSS.0000000000001944.
We conducted a systematic umbrella review to evaluate the literature relating to effects of physical activity on pain, physical function, health-related quality of life, comorbid conditions and osteoarthritis (OA) structural disease progression in individuals with lower-extremity OA.
Our primary search encompassed 2011 to February 2018 for existing systematic reviews (SR), meta-analyses (MA) and pooled analyses dealing with physical activity including exercise (not mixed with any other intervention and compared to a no-activity control group). A supplementary search encompassed 2006 to February 2018 for original research related to physical activity (including exercise) and lower limb OA progression. Study characteristics were abstracted, and risk of bias was assessed.
Physical activity decreased pain and improved physical function (strong evidence) and improved health-related quality of life (moderate evidence) among people with hip or knee OA relative to less active adults with OA. There was no evidence to suggest accelerated OA progression for physical activity below 10,000 steps per day. Both physical activity equivalent to the 2008 Physical Activity Guidelines for Americans (150 min·wk of moderate-intensity exercise in bouts ≥10 min) and lower levels of physical activity (at least 45 total minutes per week of moderate-intensity) were associated with improved or sustained high function. No SR/MA addressing comorbid conditions in OA were found. Measurable benefits of physical activity appeared to persist for periods of up to 6 months following cessation of a defined program.
People with lower-extremity OA should be encouraged to engage in achievable amounts of physical activity, of even modest intensities. They can choose to accrue minutes of physical activity throughout the entire day, irrespective of bout duration, and be confident in gaining some health and arthritis-related benefits.
我们进行了系统的伞式综述，以评估有关下肢 OA 患者体力活动对疼痛、身体功能、健康相关生活质量、合并症和骨关节炎（OA）结构疾病进展影响的文献。
我们的主要检索范围是 2011 年至 2018 年 2 月，以获取有关体力活动（包括运动，但不与任何其他干预措施混合且与不活动对照组进行比较）的现有系统综述（SR）、荟萃分析（MA）和汇总分析。补充检索范围是 2006 年至 2018 年 2 月，以获取与体力活动（包括运动）和下肢 OA 进展相关的原始研究。提取研究特征，并评估偏倚风险。
与活动量较少的 OA 患者相比，体力活动可降低疼痛并改善髋或膝 OA 患者的身体功能（强证据）和健康相关生活质量（中等证据）。每天进行低于 10,000 步的体力活动并没有加速 OA 进展的证据。相当于 2008 年美国体力活动指南（10 分钟以上的中强度运动 150 分钟/周）的体力活动和较低水平的体力活动（每周至少 45 分钟的中强度运动）都与改善或维持较高功能有关。未发现针对 OA 合并症的 SR/MA。体力活动的可衡量益处似乎在停止规定计划后长达 6 个月内持续存在。
应鼓励下肢 OA 患者进行可实现的体力活动量，即使强度较低。他们可以选择在一整天中积累体力活动分钟数，而不考虑持续时间，并确信会获得一些健康和关节炎相关的益处。
