National Taiwan University and Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
Shuang Ho Hospital and Taipei Medical University, Taipei, Taiwan.
Arthritis Care Res (Hoboken). 2020 Dec;72(12):1703-1718. doi: 10.1002/acr.24097.
To investigate the effect of muscle strength exercise training (MSET) on lean mass (LM) gain and muscle hypertrophy in older patients with lower extremity osteoarthritis (OA).
A comprehensive search of online databases was performed on April 20, 2019. Randomized controlled trials (RCTs) that reported the effects of MSET on LM, muscle thickness, and cross-sectional area (CSA) in older patients with OA were identified. A risk of bias assessment and meta-analysis were performed for the included RCTs.
We included 19 RCTs with a median Physiotherapy Evidence Database score of 6 of 10 (range 3-7). In total, data from 1,195 patients (65% women, 85% with knee OA) with a mean age of 62.1 years (range 40-86 years) were analyzed. MSET resulted in significantly higher LM gain (standardized mean difference [SMD] 0.49 [95% confidence interval (95% CI) 0.28, 0.71], P < 0.00001) than did the nonexercise controls. Meta-analysis results revealed significantly positive effects of MSET on muscle thickness (SMD 0.82 [95% CI 0.20, 1.43], P = 0.009) and CSA (SMD 0.80 [95% CI 0.25, 1.35], P = 0.004) compared with nonexercise controls. No significant effects in favor of MSET were observed for any muscle outcome compared with exercise controls. Five RCTs reported nonsevere adverse events in response to MSET, whereas no RCTs reported severe events.
MSET is effective in increasing LM and muscle size in older adults with OA. Clinicians should incorporate MSET into their management of patients at risk of low muscle mass to maximize health status, particularly for older individuals with OA.
研究肌肉力量训练（MSET）对老年下肢骨关节炎（OA）患者瘦体重（LM）增加和肌肉肥大的影响。
于 2019 年 4 月 20 日对在线数据库进行全面检索。确定了报告 MSET 对老年 OA 患者 LM、肌肉厚度和横截面积（CSA）影响的随机对照试验（RCT）。对纳入的 RCT 进行偏倚风险评估和荟萃分析。
我们纳入了 19 项 RCT，其 Physiotherapy Evidence Database 评分中位数为 10 分中的 6 分（范围 3-7 分）。共有 1195 例患者（65%为女性，85%为膝骨关节炎）的数据纳入分析，平均年龄为 62.1 岁（范围 40-86 岁）。MSET 导致 LM 增加显著高于非运动对照组（标准化均数差 [SMD] 0.49 [95%置信区间（95%CI）0.28，0.71]，P < 0.00001）。荟萃分析结果显示，MSET 对肌肉厚度（SMD 0.82 [95%CI 0.20，1.43]，P = 0.009）和 CSA（SMD 0.80 [95%CI 0.25，1.35]，P = 0.004）的影响明显优于非运动对照组。与运动对照组相比，MSET 对任何肌肉结果均无显著有利影响。5 项 RCT 报告了对 MSET 的非严重不良事件，而没有 RCT 报告严重事件。
MSET 可有效增加老年 OA 患者的 LM 和肌肉大小。临床医生应将 MSET 纳入其对低肌肉量风险患者的管理中，以最大限度地提高健康状况，尤其是对老年 OA 患者。
