Department of Physical Education, 12538Nankai University, Tianjin, China.
China Swimming College, 47838Beijing Sport University, Beijing, China.
Clin Rehabil. 2023 Mar;37(3):330-347. doi: 10.1177/02692155221134240. Epub 2022 Nov 1.
To examine the efficacy and safety of aquatic exercise for people with knee osteoarthritis.
PubMed, Web of Science, Embase, CENTRAL, CNKI and WanFang databases were searched from 1966 to September 2022.
Randomized controlled trials evaluating aquatic exercise for people with knee osteoarthritis compared with no exercise and land-based exercise were included. The Grading of Recommendations Assessment, Development and Evaluation system was used to evaluate the certainty of evidence.
Twenty-two studies with 1394 participants were included. Compared with no exercise (13 trials with 746 participants), low-to high-certainty evidence revealed that aquatic exercise yielded significant improvements in patient-reported pain (SMD -0.58, 95% CI -0.82 to -0.33), stiffness (SMD -0.57, 95% CI -1.03 to -0.11) and physical function (SMD -0.35, 95% CI -0.52 to -0.18) immediately postintervention. A sustained effect was observed only for pain at three months postintervention (SMD -0.48, 95% CI -0.91 to -0.06). The confidence intervals demonstrated that the pooled results do not exclude the minimal clinically important differences. There were no significant differences between the effects of aquatic exercise and land-based exercise (13 trials with 648 participants) on pain (SMD -0.12, 95% CI -0.29 to 0.04), stiffness (SMD -0.17, 95% CI -0.49 to 0.16) or physical function (SMD -0.13, 95% CI -0.28 to 0.02). No study reported a serious adverse event in relation to aquatic exercise.
Aquatic exercise provides a short-term clinical benefit that is sustained for at least three months postintervention in terms of pain in people with knee osteoarthritis.
研究水疗运动对膝骨关节炎患者的疗效和安全性。
检索 1966 年至 2022 年 9 月的 PubMed、Web of Science、Embase、CENTRAL、CNKI 和万方数据库。
纳入比较水疗运动与不运动和陆地运动对膝骨关节炎患者的随机对照试验。采用推荐评估、制定与评价系统评估证据的确定性。
纳入 22 项研究共 1394 名参与者。与不运动（13 项研究共 746 名参与者）相比，低到高确定性证据表明，水疗运动即刻干预后患者报告的疼痛（SMD-0.58，95%CI-0.82 至-0.33）、僵硬（SMD-0.57，95%CI-1.03 至-0.11）和身体功能（SMD-0.35，95%CI-0.52 至-0.18）均有显著改善。仅在干预后 3 个月时观察到疼痛的持续效应（SMD-0.48，95%CI-0.91 至-0.06）。置信区间表明，汇总结果不排除最小临床重要差异。水疗运动与陆地运动（13 项研究共 648 名参与者）对疼痛（SMD-0.12，95%CI-0.29 至 0.04）、僵硬（SMD-0.17，95%CI-0.49 至 0.16）或身体功能（SMD-0.13，95%CI-0.28 至 0.02）的影响无显著差异。没有研究报道与水疗运动相关的严重不良事件。
水疗运动为膝骨关节炎患者提供了短期的临床获益，至少在干预后 3 个月内持续缓解疼痛。
