Mauri C, Cerulli C, Grazioli E, Minganti C, Tranchita E, Scotto di Palumbo A, Parisi A
Unit of Physical Exercise and Sport Sciences, Department of Movement, Human and Health Sciences, University of Rome «Foro Italico», Piazza Lauro De Bosis 15, 00135, Rome, Italy.
Ann Phys Rehabil Med. 2025 Apr;68(3):101909. doi: 10.1016/j.rehab.2024.101909. Epub 2025 Jan 10.
Osteoarthritis (OA) is a complex disease that causes pain, stiffness and swelling, limiting function and mobility, thus interfering with daily life and affecting personal, social, and psychological aspects of life.
To evidence the role of exercise on pain reduction and the effectiveness of one type of training over another in terms of pain, functional capacity, and inflammatory biomarkers in OA.
Studies retrieved from Web of Science, PubMed and Scopus databases were systematically reviewed. RCTs involving physical exercise interventions in participants with OA were included. The 3 main outcomes considered in the systematic review were pain, functional capacity and inflammatory biomarkers. The effects of different types of interventions (aerobic, resistance, combined, neuromuscular and others) were analysed for each outcome. Systematic review and meta-analysis were conducted following the PRISMA Statement.
21 studies were included in the systematic review and 11 in the meta-analysis. The meta-analysis was conducted on pain in training intervention subgroups, showing a larger effect size for neuromuscular training -2,26 (95 % CI -4,37 to -0,14). Functional capacity and inflammatory biomarkers were analysed only with a systematic review because it was not possible to estimate the efficacy of the different training protocols with a meta-analysis.
Neuromuscular training protocols seem to be the most effective in reducing pain in OA. Direct comparison of different training treatment options on functional capacity and inflammatory biomarkers for OA is not currently feasible in practice, due to the heterogeneity of the test and the small number of studies. High-quality physical exercise intervention studies are warranted to estimate their effectiveness more accurately on pain, functional capacity, and inflammatory status in OA.
CRD42023481061.
骨关节炎（OA）是一种复杂的疾病，会导致疼痛、僵硬和肿胀，限制功能和活动能力，从而干扰日常生活，并影响生活的个人、社交和心理方面。
证明运动在减轻疼痛方面的作用，以及一种训练类型相对于另一种训练类型在OA患者的疼痛、功能能力和炎症生物标志物方面的有效性。
系统检索了Web of Science、PubMed和Scopus数据库中的研究。纳入了涉及对OA患者进行体育锻炼干预的随机对照试验（RCT）。系统评价中考虑的3个主要结局是疼痛、功能能力和炎症生物标志物。分析了不同类型干预措施（有氧运动、阻力运动、联合运动、神经肌肉运动等）对每个结局的影响。按照PRISMA声明进行系统评价和荟萃分析。
系统评价纳入21项研究，荟萃分析纳入11项研究。对训练干预亚组的疼痛进行了荟萃分析，结果显示神经肌肉训练的效应量更大，为-2.26（95%CI -4.37至-0.14）。仅通过系统评价分析了功能能力和炎症生物标志物，因为无法通过荟萃分析估计不同训练方案的疗效。
神经肌肉训练方案似乎在减轻OA疼痛方面最有效。由于测试的异质性和研究数量较少，目前在实践中直接比较不同训练治疗方案对OA功能能力和炎症生物标志物的影响尚不可行。需要高质量的体育锻炼干预研究，以更准确地评估其对OA疼痛、功能能力和炎症状态的有效性。
PROSPERO注册号：CRD42023481061。
