Young James J, Pedersen Julie Rønne, Bricca Alessio
Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Canada.
Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Curr Treatm Opt Rheumatol. 2023 May 20:1-17. doi: 10.1007/s40674-023-00205-z.
Exercise therapy is the first line treatment for patients with knee and hip osteoarthritis (OA) but is consistently underutilized. In this review, we aim to provide health care professionals with an overview of the latest evidence in the areas of exercise therapy for OA, which can serve as a guide for incorporating the ideal exercise therapy prescription in the overall management plan for their patients with OA.
Evidence continues to be produced supporting the use of exercise therapy for all patients with knee or hip OA. Ample evidence exists suggesting exercise therapy is a safe form of treatment, for both joint structures and the patient overall. Several systematic reviews show that exercise therapy is likely to improve patient outcomes, regardless of disease severity or comorbidities. However, no single type of exercise therapy is superior to others.
Health care practitioners and patients should be encouraged to incorporate exercise therapy into treatment plans and can be assured of the safety profile and likelihood of improvement in important patient outcomes. Since no single exercise therapy program shows vastly superior benefit, patient preference and contextual factors should be central to the shared decision-making process when selecting and individualising appropriate exercise therapy prescriptions.
运动疗法是膝关节和髋关节骨关节炎(OA)患者的一线治疗方法,但一直未得到充分利用。在本综述中,我们旨在为医疗保健专业人员提供OA运动疗法领域最新证据的概述,这可为将理想的运动疗法处方纳入其OA患者的整体管理计划提供指导。
继续有证据支持对所有膝关节或髋关节OA患者使用运动疗法。有充分证据表明,运动疗法对关节结构和患者整体而言都是一种安全的治疗方式。多项系统评价表明,无论疾病严重程度或合并症如何,运动疗法都可能改善患者的预后。然而,没有一种运动疗法比其他疗法更优越。
应鼓励医疗保健从业者和患者将运动疗法纳入治疗计划,并可确保其安全性以及改善重要患者预后的可能性。由于没有单一的运动疗法方案显示出极大的优越性,因此在选择和个性化适当的运动疗法处方时,患者的偏好和背景因素应成为共同决策过程的核心。