运动疗法对类风湿关节炎和膝骨关节炎患者疼痛、疲劳、骨功能及炎症生物标志物的影响：随机对照试验的荟萃研究综述

The effect of exercise therapy on pain, fatigue, bone function and inflammatory biomarkers individuals with rheumatoid arthritis and knee osteoarthritis: a meta-research review of randomized controlled trials.

作者信息

Fu Xiaoting, Zhang Liang, Wang Cuijuan, Yue Jun, Zhu Hang

机构信息

Orthopedics Department, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou City, China.

出版信息

Front Physiol. 2025 Apr 9;16:1558214. doi: 10.3389/fphys.2025.1558214. eCollection 2025.

DOI:10.3389/fphys.2025.1558214

PMID:40271213

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12014597/

Abstract

BACKGROUND

Accumulating evidence suggested the potential role of exercise in alleviating rheumatoid arthritis (RA). However, whether exercise improves physical function (walk test, grip strength, muscle strength, joint assessments) and inflammatory biomarkers in patients with RA is unclear. This umbrella meta-analysis aimed to examine the effect of exercise in patients with RA.

METHOD

PubMed, Scopus, Web of Science, Embase, and Cochrane Central Library databases were systematically searched for meta-analyses of randomized control trials (RCTs) to retrieve relevant studies. The effect sizes were pooled using a random-effects model, with standardized or weighted mean differences (SMDs or WMDs) and 95% confidence intervals (CIs) as summary statistics.

RESULTS

Seventeen studies were included. The improving effects of exercise on fatigue levels (SMD = -0.28, 95% CI: -0.44, -0.13), pain intensity (ES = -0.50, 95% CI: -0.87, -0.14), disease activity score in joints (DAS) (WMD = -0.54, 95% CI: -0.99, -0.09; and SMD = -0.47, 95% CI: -0.64, -0.30), and ESR (ES = -0.85, 95% CI: -1.66, -0.03) were significant. No significant impact on the hand grip, muscle strength, walk test, joints and inflammatory biomarkers was observed.

CONCLUSION

Exercise significantly reduces fatigue, pain, DAS, and ESR in RA but shows no impact on grip strength, muscle strength, walk test, joints, or other inflammatory biomarkers. This highlights its role in symptom management rather than broad physiological changes.

摘要

背景

越来越多的证据表明运动在缓解类风湿性关节炎（RA）方面具有潜在作用。然而，运动是否能改善RA患者的身体功能（步行测试、握力、肌肉力量、关节评估）和炎症生物标志物尚不清楚。这项伞状荟萃分析旨在研究运动对RA患者的影响。

方法

系统检索了PubMed、Scopus、Web of Science、Embase和Cochrane Central Library数据库，以获取随机对照试验（RCT）的荟萃分析，从而检索相关研究。使用随机效应模型汇总效应量，以标准化或加权平均差（SMD或WMD）以及95%置信区间（CI）作为汇总统计量。

结果

纳入了17项研究。运动对疲劳水平（SMD = -0.28，95% CI：-0.44，-0.13）、疼痛强度（ES = -0.50，95% CI：-0.87，-0.14）、关节疾病活动评分（DAS）（WMD = -0.54，95% CI：-0.99，-0.09；以及SMD = -0.47，95% CI：-0.64，-0.30）和红细胞沉降率（ES = -0.85，95% CI：-1.66，-0.03）具有显著改善作用。未观察到对握力、肌肉力量、步行测试、关节和炎症生物标志物有显著影响。