Su Shan, Yu Clare Chung-Wah, Zhou Emma Feng-Ming, Liu Jing-Yuan, Fu Siu-Ngor
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR.
Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR.
BMC Musculoskelet Disord. 2025 Jun 3;26(1):549. doi: 10.1186/s12891-025-08746-1.
Although aerobic exercise is widely recommended to enhance cardiopulmonary fitness and mitigate cardiovascular risk, the efficacy and effectiveness of aerobic exercise interventions have not been comprehensively evaluated among people with knee osteoarthritis (OA). This systematic review and meta-analysis aimed to synthesize the current evidence on the impact of aerobic exercise on cardiopulmonary fitness in people with knee OA.
PubMed, Embase, Scopus, and Web of Science were searched from inception to March 1, 2024, for randomized controlled trials (RCTs). Eligible RCTs included those with an aerobic exercise intervention (e.g., aerobic walking, cycling, aquatic aerobics), a primary outcome of maximum oxygen consumption (VO max), and participants with knee OA. The aerobic exercise programs were compared to control interventions (e.g., education, light-intensity exercise, usual activities, and routine care). Secondary outcomes included distance (m) walked during the six-minute walk test (6MWD), and Patient-Reported Outcome Measures (i.e., pain score and disability score). The overall level of evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
Out of 988 studies, 5 RCTs with 459 people with knee OA were included in the analysis. Aerobic exercise programs included walking, cycling, jumping, stepping, and aquatic aerobics. Pooled mean differences and 95% confidence intervals (CIs) were 0.90 ml/kg/min (95% CI 0.43 to 1.38; moderate evidence), 46.97 m (95% CI 33.71 to 60.23; high evidence), 5.59 points (95% CI 2.93 to 8.25; low evidence), and 3.03 points (95% CI 1.05 to 5.01; moderate evidence) for VO max, 6MWD, pain and disability, respectively.
These results support the hypothesis that aerobic exercise can elicit improvements in cardiopulmonary fitness for people with knee OA. Future research should focus on optimizing current exercise regimens for people with knee OA and exploring how to improve adherence while minimizing symptom exacerbation by other exercise modalities, e.g., Nordic walking and inspiratory muscle training.
CRD42022340966, 07/07/2022, PROSPERO.
尽管有氧运动被广泛推荐用于增强心肺功能和降低心血管风险，但有氧运动干预对膝骨关节炎（OA）患者的疗效和效果尚未得到全面评估。本系统评价和荟萃分析旨在综合当前关于有氧运动对膝OA患者心肺功能影响的证据。
检索了PubMed、Embase、Scopus和Web of Science数据库，检索时间从建库至2024年3月1日，查找随机对照试验（RCT）。符合条件的RCT包括那些进行有氧运动干预（如有氧步行、骑自行车、水中有氧运动）、以最大摄氧量（VO₂max）为主要结局且参与者为膝OA患者的研究。将有氧运动方案与对照干预措施（如教育、低强度运动、日常活动和常规护理）进行比较。次要结局包括六分钟步行试验（6MWD）中的步行距离（米）以及患者报告结局指标（即疼痛评分和残疾评分）。证据的总体水平采用推荐分级评估、制定与评价（GRADE）方法进行评估。
在988项研究中，有5项RCT（共459名膝OA患者）纳入分析。有氧运动方案包括步行、骑自行车、跳跃、踏步和水中有氧运动。合并平均差和95%置信区间（CI）分别为：VO₂max为0.90 ml/kg/min（95% CI 0.43至1.38；中等证据），6MWD为46.97米（95% CI 33.71至60.23；高证据）；疼痛评分为5.59分（95% CI 2.93至8.25；低证据）；残疾评分为3.03分（95% CI 1.05至5.01；中等证据）。
这些结果支持以下假设：有氧运动可使膝OA患者的心肺功能得到改善。未来的研究应侧重于为膝OA患者优化当前的运动方案，并探索如何提高依从性，同时尽量减少其他运动方式（如越野行走和吸气肌训练）导致的症状加重。
CRD42022340966，2022年7月7日，PROSPERO。
