Guede-Rojas Francisco, Benavides-Villanueva Alexis, Salgado-González Sergio, Mendoza Cristhian, Arias-Álvarez Gonzalo, Soto-Martínez Adolfo, Carvajal-Parodi Claudio
Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, 7591538, Chile.
Universidad San Sebastián, Programa Magíster en Kinesiología Musculoesquelética, Lientur #1457, Concepción, Chile.
Sports Med Health Sci. 2023 Nov 7;6(2):101-110. doi: 10.1016/j.smhs.2023.10.005. eCollection 2024 Jun.
Proprioception is significantly impaired in knee osteoarthritis (KOA), contributing to reduced functionality. Strength training (ST) is essential in KOA by improving muscle strength, although it may also be effective in improving proprioception. The purpose was to determine the effect of ST on knee proprioception in KOA patients. Pubmed, CINAHL, Scopus, WOS, and PEDro were searched for randomized controlled trials (RCTs) (inception to March 2023). Comparisons for ST were physical exercise different from ST, non-exercise-based interventions, and no intervention. Methodological quality was assessed using the PEDro scale, and risk of bias (RoB) using the Cochrane tool. Meta-analyses were performed by comparison groups using the standardized mean difference (SMD) (Hedge's ) with random effects models, also considering subgroups by proprioception tests. Finally, six RCTs were included. The mean PEDro score was 6.3, and the highest proportion of biases corresponds to performance, selection, and detection. The meta-analysis indicated that only when compared with non-intervention, ST significantly improved knee proprioception for the joint position sense (JPS) (active + passive), JPS (passive), and threshold to detect passive motion (TTDPM) subgroups ( = -1.33 [-2.33, -0.32], = -2.29 [-2.82, -1.75] and = -2.40 [-4.23, -0.58], respectively). However, in the knee JPS (active) subgroup, ST was not significant ( = -0.72 [-1.84, 0.40]). In conclusion, ST improves knee proprioception compared to non-intervention. However, due to the paucity of studies and diversity of interventions, more evidence is needed to support the effectiveness of ST. Future RCTs may address the limitations of this review to advance knowledge about proprioceptive responses to ST and contribute to clinical practice.
本体感觉在膝关节骨关节炎（KOA）中显著受损，导致功能下降。力量训练（ST）对KOA至关重要，它可以改善肌肉力量，尽管其在改善本体感觉方面可能也有效。本研究旨在确定ST对KOA患者膝关节本体感觉的影响。检索了PubMed、CINAHL、Scopus、WOS和PEDro数据库，查找随机对照试验（RCTs）（从创刊至2023年3月）。将ST与不同于ST的体育锻炼、非基于运动的干预措施以及不进行干预进行比较。使用PEDro量表评估方法学质量，使用Cochrane工具评估偏倚风险（RoB）。采用随机效应模型，通过比较组使用标准化均数差（SMD）（Hedge's ）进行Meta分析，同时考虑本体感觉测试的亚组。最终纳入了六项RCTs。PEDro平均评分为6.3，偏倚比例最高的是表现、选择和检测方面。Meta分析表明，仅与不进行干预相比，ST在关节位置觉（JPS）（主动 + 被动）、JPS（被动）和检测被动运动阈值（TTDPM）亚组中显著改善了膝关节本体感觉（分别为 = -1.33 [-2.33, -0.32]， = -2.29 [-2.82, -1.75]和 = -2.40 [-4.23, -0.58]）。然而，在膝关节JPS（主动）亚组中，ST不显著（ = -0.72 [-1.84, 0.40]）。总之，与不进行干预相比，ST可改善膝关节本体感觉。然而，由于研究较少且干预措施多样，需要更多证据来支持ST的有效性。未来的RCTs可能会解决本综述的局限性，以推进关于对ST的本体感觉反应的认识，并为临床实践做出贡献。
