Zhang Weijun, Roster Katie, Hays Ron D, Wang Chenchen
Center for East-West Medicine, Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
J Altern Complement Med. 2021 May;27(5):442-457. doi: 10.1089/acm.2020.0420. Epub 2021 Apr 27.
Clear and complete reporting of the components of complex interventions is required in clinical trials to ensure that research can be reliably replicated and successfully translated into clinical practice. Movement-based mind-body exercises, such as Tai Chi, , and Yoga (TQY), are considered complex interventions and recommended for individuals with osteoarthritis in the latest guidelines of the American College of Rheumatology. This review analyzes the intervention reporting of randomized controlled trials of TQY to guide the implementation in osteoarthritis exercise programs. We searched PubMed, Cochrane Central Register of Controlled Trials, and EMBASE for TQY exercise trials in osteoarthritis between 2000 and 2020. Pairs of researchers independently screened the records, extracted study characteristics, and assessed 19 items on the Consensus on Exercise Reporting Template (CERT) checklist. For each of these items, the numbers of studies that clearly reported the item were calculated. We then identified the items in the studies that are key to delivering home-based exercises for further analysis. We included 27 publications reporting 22 TQY interventions in the analysis. None of the studies reported sufficient details on all the 19 CERT items. The median completeness of reporting score was 11 and ranged from 6 to 15 of 19. The most frequently incompletely reported items (number reporting and percentage of studies) were "starting level rule" ( = 1, 5%) and "progression rule" ( = 1, 5%). Other incompletely reported items included "fidelity or adherence (planned)" ( = 9, 41%), "motivations" ( = 9, 41%), and "progression description" ( = 5, 23%). The content analysis highlights motivational strategies for long-term adherence to home-based exercises, which may help clinicians develop interventions for their patients. Details of TQY exercises interventions for osteoarthritis are incompletely reported in the included studies. The study suggests that improvements in content reporting are especially needed on items related to exercise intensity and program progression decisions, and motivational strategies in future implementation.
在临床试验中,需要清晰、完整地报告复杂干预措施的组成部分,以确保研究能够可靠地重复进行,并成功转化为临床实践。基于运动的身心锻炼,如太极拳、八段锦和瑜伽(TQY),被视为复杂干预措施,并在美国风湿病学会的最新指南中推荐给骨关节炎患者。本综述分析了TQY随机对照试验的干预报告,以指导其在骨关节炎运动项目中的实施。我们在PubMed、Cochrane对照试验中心注册库和EMBASE中检索了2000年至2020年间关于骨关节炎的TQY运动试验。两位研究人员独立筛选记录,提取研究特征,并根据运动报告模板共识(CERT)清单评估19项内容。对于这些项目中的每一项,计算明确报告该项目的研究数量。然后,我们确定研究中对于提供家庭锻炼至关重要的项目,以便进一步分析。我们纳入了27篇报告22项TQY干预措施的出版物进行分析。没有一项研究报告了所有19项CERT项目的充分细节。报告得分的中位数为11,在19项中范围为6至15。报告最不完整的项目(报告数量和研究百分比)是“起始水平规则”(n = 1,5%)和“进展规则”(n = 1,5%)。其他报告不完整的项目包括“保真度或依从性(计划)”(n = 9,41%)、“动机”(n = 9,41%)和“进展描述”(n = 5,23%)。内容分析突出了长期坚持家庭锻炼的动机策略,这可能有助于临床医生为患者制定干预措施。纳入研究中关于骨关节炎的TQY锻炼干预措施的细节报告不完整。该研究表明,在未来的实施中,尤其需要改进与运动强度和项目进展决策相关项目以及动机策略的内容报告。