van Baar M E, Dekker J, Oostendorp R A, Bijl D, Voorn T B, Lemmens J A, Bijlsma J W
Netherlands Institute of Primary Health Care, Utrecht.
J Rheumatol. 1998 Dec;25(12):2432-9.
To determine the effectiveness of exercise therapy in patients with osteoarthritis (OA) of the hip or knee.
A randomized single blind, clinical trial was conducted in a primary care setting. Patients with hip or knee OA by American College of Rheumatology criteria were selected. Two intervention groups were compared. Both groups received treatment from the patients' general practitioner, including patient education and medication if necessary. The experimental group also received exercise therapy from a physiotherapist in primary care. The treatment period was 12 weeks. The main outcome measures were pain, medication use (nonsteroidal antiinflammatory drugs, NSAID) and observed disability.
A total of 201 patients were randomized. Exercise therapy was associated with a reduction of pain in the past week (difference in change -17.0; 95% CI -23.6, -10.4) and observed disability (-0.19; 95% CI -0.38; -0.01). Effect sizes were medium (0.58) and small (0.28), respectively. No effect of exercise therapy was found for the use of NSAID. Additional beneficial effects (p = 0.05) were found for the use of paracetamol (effect size 0.33), global effect as perceived by the patient (effect size 0.68), and muscle strength of the hip (effect size 0.34).
After 12 weeks, exercise therapy is effective in reducing pain and disability. The size of the effects is medium and small, respectively.
确定运动疗法对髋或膝骨关节炎（OA）患者的有效性。
在初级保健机构中进行了一项随机单盲临床试验。根据美国风湿病学会标准选择髋或膝OA患者。比较两个干预组。两组均接受患者全科医生的治疗，必要时包括患者教育和药物治疗。实验组还接受了初级保健物理治疗师的运动疗法。治疗期为12周。主要结局指标为疼痛、药物使用（非甾体抗炎药，NSAID）和观察到的残疾情况。
共有201名患者被随机分组。运动疗法与过去一周疼痛减轻（变化差异-17.0；95%可信区间-23.6，-10.4）和观察到的残疾减轻（-0.19；95%可信区间-0.38；-0.01）相关。效应大小分别为中等（0.58）和小（0.28）。未发现运动疗法对NSAID使用有影响。对扑热息痛的使用（效应大小0.33）、患者感知的总体效果（效应大小0.68）和髋部肌肉力量（效应大小0.34）发现了额外的有益效果（p = 0.05）。
12周后，运动疗法在减轻疼痛和残疾方面有效。效果大小分别为中等和小
