Liu Hao, Qin Lei, Liu Yanhong, Meng Xiangxiang, Li Chunjun, He Ming
Neck-Shoulder and Lumbocrural Pain Hospital of Shandong First Medical University, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250000, Shandong, China.
Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250000, Shandong, China.
Eur J Med Res. 2025 Aug 31;30(1):826. doi: 10.1186/s40001-025-03083-4.
Knee osteoarthritis (KOA) is a prevalent, debilitating chronic joint disease characterized by pain, stiffness, and functional limitations. Non-pharmacological rehabilitation is a fundamental management strategy. This narrative review synthesizes evidence on an integrated KOA rehabilitation framework, including: exercise therapy (aerobic, resistance, neuromuscular training), which reduces pain and improves function through enhanced muscle activation and joint stability; dietary interventions (weight management and anti-inflammatory diets), which lower mechanical load and systemic inflammation; biomechanical optimization (bracing, gait retraining), aimed at reducing joint stress; and physical therapist-guided strategies (individualized exercises, manual therapy, patient education) addressing pain and functional restoration. While these core components demonstrate synergistic potential and highlight the need for personalized approaches, the review notes suboptimal adherence to guideline-recommended therapies in clinical practice. Additionally, supplementary treatments such as manual therapy and acupuncture, although commonly used, lack strong evidence, characterized by low-quality Randomized controlled trials, insufficient sample sizes, and inconsistent findings. This situation warrants further robust research. Future studies should focus on personalized approaches that utilize machine learning, mobile health tools for real-time gait analysis, and novel biotechnologies to address the remaining challenges. This review aims to provide clinicians and researchers with a practical guide to optimize KOA rehabilitation, enhancing patient care and quality of life.
膝骨关节炎（KOA）是一种常见的、使人衰弱的慢性关节疾病，其特征为疼痛、僵硬和功能受限。非药物康复是一种基本的管理策略。本叙述性综述综合了关于KOA综合康复框架的证据，包括：运动疗法（有氧运动、抗阻运动、神经肌肉训练），通过增强肌肉激活和关节稳定性来减轻疼痛并改善功能；饮食干预（体重管理和抗炎饮食），以降低机械负荷和全身炎症；生物力学优化（支具、步态再训练），旨在减轻关节压力；以及物理治疗师指导的策略（个性化运动、手法治疗、患者教育），以解决疼痛和功能恢复问题。虽然这些核心组成部分显示出协同潜力并突出了个性化方法的必要性，但该综述指出临床实践中对指南推荐疗法的依从性欠佳。此外，诸如手法治疗和针灸等辅助治疗虽然常用，但缺乏有力证据，其特点是随机对照试验质量低、样本量不足且结果不一致。这种情况需要进一步开展有力的研究。未来的研究应侧重于利用机器学习、用于实时步态分析的移动健康工具和新型生物技术的个性化方法，以应对剩余的挑战。本综述旨在为临床医生和研究人员提供一份实用指南，以优化KOA康复，提高患者护理水平和生活质量。
