Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India.
BMC Musculoskelet Disord. 2022 Jun 29;23(1):622. doi: 10.1186/s12891-022-05557-6.
Globally osteoarthritis of the knee is a leading cause of disability. Hip abductor strength and activation are essential for maintaining postural balance during transfers and are related to joint loading and progression during weight-bearing activities. Strength deficits in the hip abductors might cause a reduction in the lower extremity force generation, thereby causing stress on the medial tibiofemoral joint. The aim of this systematic review is to assess the effectiveness of hip abductor strengthening on knee joint loading, knee pain and functional outcome measures in patients with knee osteoarthritis.
Database such as Scopus, PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL) database and PEDro were reviewed to recognize the trials published in English from inception to December 2020. Randomized controlled trials that studied the effectiveness of hip abductor strengthening in subjects with knee osteoarthritis and its impact on knee joint loading, knee pain and functional outcome measures were included. RevMan 5.4 was used for meta-analysis and forest plot construction. Quality assessment of the included studies was carried out using the PEDro scale.
The search yielded 260 results of which 29 full-text articles were screened. The review includes 7 randomized controlled trials and 3 studies with good methodological quality were included for meta-analysis. The meta-analysis of the articles favored hip abductor strengthening intervention over the control group. Hip abductor strengthening had significantly reduced the VAS [ SMD = -0.60[-0.88, -0.33] p < 0.0001]at 95% CI and improved the WOMAC scores [SMD - 0.75[-1.05,-0.45] p < 0.0001] at 95% CI. All of the included studies concluded that strengthening the hip abductor muscle had a positive impact on knee pain and functional outcomes.
The current study found high-quality evidence to support the use of hip abductor muscle strengthening exercises as a rehabilitative treatment for subjects with knee osteoarthritis.
CRD42021256251 .
全球范围内，膝关节骨关节炎是导致残疾的主要原因。髋关节外展肌的力量和激活对于在转移过程中保持姿势平衡至关重要，并且与负重活动期间的关节负荷和进展有关。髋关节外展肌无力可能会导致下肢力量产生减少，从而导致内侧胫股关节承受压力。本系统评价旨在评估髋关节外展肌强化对膝关节骨关节炎患者膝关节负荷、膝关节疼痛和功能结果测量的有效性。
检索 Scopus、PubMed、EMBASE、Cochrane 对照试验中心注册库（CENTRAL）数据库和 PEDro 以识别从开始到 2020 年 12 月发表的英文试验。纳入研究髋关节外展肌强化对膝关节骨关节炎患者的有效性及其对膝关节负荷、膝关节疼痛和功能结果测量的影响的随机对照试验。使用 RevMan 5.4 进行荟萃分析和森林图构建。使用 PEDro 量表对纳入研究进行质量评估。
搜索结果产生了 260 个结果，其中筛选了 29 篇全文文章。该综述包括 7 项随机对照试验，其中 3 项研究具有良好的方法学质量，纳入进行荟萃分析。文章的荟萃分析倾向于髋关节外展肌强化干预优于对照组。髋关节外展肌强化显著降低了视觉模拟量表（VAS）[SMD=-0.60[-0.88，-0.33]p<0.0001]95%置信区间，并改善了 WOMAC 评分[SMD-0.75[-1.05，-0.45]p<0.0001]95%置信区间。所有纳入的研究都得出结论，加强髋关节外展肌对膝关节疼痛和功能结果有积极影响。
本研究发现高质量证据支持使用髋关节外展肌强化锻炼作为膝关节骨关节炎患者的康复治疗。
CRD42021256251。
