基于移动健康的运动与传统运动对膝骨关节炎患者疼痛、功能障碍及生活质量的影响：一项随机对照试验的系统评价与荟萃分析
mHealth-based exercise vs. traditional exercise on pain, functional disability, and quality of life in patients with knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials.
作者信息
Tang Liang, Wang Meng-Ming, Wang He-Xia, He Xiao-Ya, Jiang Yue-Shuai
机构信息
College of Physical Education and Arts Humanities, China University of Petroleum (Beijing), Beijing, China.
Law School, Case Western Reserve University, Cleveland, OH, United States.
出版信息
Front Physiol. 2025 Jan 3;15:1511199. doi: 10.3389/fphys.2024.1511199. eCollection 2024.
OBJECTIVE
This study aims to compare the efficacy of mHealth-based exercise interventions with traditional exercise in improving pain intensity, functional disability, and quality of life in patients suffering from knee osteoarthritis (OA).
METHOD
Randomized controlled trials (RCTs) published from their inception to 23 August 2024 were searched in Cochrane, Embase, Medline, Web of Science. Reviewer pairs independently extracted data and evaluated bias using the Cochrane Risk of Bias tool.
RESULTS
Eleven studies, with a total of 800 participants with a mean age of 55.51 ± 6.88 years, were identified. All RCTs were performed from 2013 to 2024. There was no statistically significant difference between mHealth-supported exercise compared with the traditional exercise without mHealth in terms of pain reduction (standard mean differences [SMD] = -0.35; 95%CI: -0.74 to 0.04, P = 0.08), functional disability (SMD = -0.5; 95%CI: -0.1 to 0.01; P = 0.05), and quality of life (SMD = 0.11; 95%CI: -0.26 to 0.48; P = 0.56). However, a statistically significant difference was found between mHealth-supported exercise compared with unsupervised traditional exercise in terms of pain (SMD = -1.03; 95%CI: -1.49 to -0.57; P < 0.001) and functional disability (SMD = -0.89; 95%CI: -1.71 to -0.06; P = 0.04).
CONCLUSION
mHealth-based exercise was found to be more effective than unsupervised conventional exercise in promoting pain relief and enhancing functional disability in patients with OA. When face-to-face exercise intervention is not feasible, mHealth-based exercise should be considered a viable option in the recovery process for knee OA. Given the significant heterogeneity observed in this study, it is important to exercise caution when extrapolating the results.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier CRD42024610393.
目的
本研究旨在比较基于移动健康技术（mHealth）的运动干预与传统运动在改善膝关节骨关节炎（OA）患者疼痛强度、功能障碍和生活质量方面的疗效。
方法
检索Cochrane、Embase、Medline、Web of Science数据库中从建库至2024年8月23日发表的随机对照试验（RCT）。评审员对独立提取数据，并使用Cochrane偏倚风险工具评估偏倚。
结果
共纳入11项研究，总计800名参与者，平均年龄为55.51±6.88岁。所有RCT均在2013年至2024年期间进行。在减轻疼痛方面（标准均值差[SMD]=-0.35；95%置信区间：-0.74至0.04，P=0.08）、功能障碍方面（SMD=-0.5；95%置信区间：-0.1至0.01；P=0.05）和生活质量方面（SMD=0.11；95%置信区间：-0.26至0.48；P=0.56），与无mHealth支持的传统运动相比，mHealth支持的运动之间无统计学显著差异。然而，在疼痛方面（SMD=-1.03；95%置信区间：-1.49至-0.57；P<0.001）和功能障碍方面（SMD=-0.89；95%置信区间：-1.71至-0.06；P=0.04），与无监督的传统运动相比，mHealth支持的运动之间存在统计学显著差异。
结论
发现基于mHealth的运动在促进OA患者疼痛缓解和改善功能障碍方面比无监督的传统运动更有效。当面授运动干预不可行时，基于mHealth的运动应被视为膝关节OA恢复过程中的一个可行选择。鉴于本研究中观察到的显著异质性，在推断结果时应谨慎。
系统评价注册
https://www.crd.york.ac.uk/PROSPERO/#recordDetails，标识符CRD42024610393。
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