Shan Su, Clare Chung-Wah Yu, Emma Feng-Ming Zhou, Jing-Yuan Liu, Siu-Ngor Fu
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引用次数: 0
Abstract
Background: 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.
Methods: 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 (VO2 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.
Results: 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 VO2 max, 6MWD, pain and disability, respectively.
Conclusion: 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.
背景：尽管有氧运动被广泛推荐用于增强心肺健康和降低心血管风险，但在膝关节骨关节炎（OA）患者中，有氧运动干预的功效和效果尚未得到全面评估。本系统综述和荟萃分析旨在综合有氧运动对膝关节OA患者心肺健康影响的现有证据。方法：检索PubMed、Embase、Scopus和Web of Science从成立到2024年3月1日的随机对照试验（RCTs）。符合条件的随机对照试验包括有氧运动干预（例如，有氧步行，骑自行车，水中有氧运动），最大耗氧量（VO2 max）的主要结局，以及膝关节OA的参与者。将有氧运动项目与对照干预（如教育、低强度运动、日常活动和日常护理）进行比较。次要结果包括6分钟步行测试（6MWD）期间的步行距离(m)和患者报告的结果测量（即疼痛评分和残疾评分）。证据的总体水平通过推荐评估、发展和评价分级（GRADE）方法进行评估。结果：在988项研究中，5项随机对照试验纳入了459例膝关节OA患者。有氧运动项目包括步行、骑自行车、跳跃、踏步和水中有氧运动。合并平均差异和95%置信区间（CI）为0.90 ml/kg/min (95% CI 0.43 ~ 1.38；中度证据),46.97 m (95% CI 33.71 ~ 60.23；高证据)，5.59点(95% CI 2.93 ~ 8.25；低证据)和3.03点(95% CI 1.05 ~ 5.01；中度证据)分别用于VO2 max， 6MWD，疼痛和残疾。结论：这些结果支持有氧运动可以改善膝关节OA患者心肺健康的假设。未来的研究应侧重于优化膝关节OA患者目前的运动方案，并探索如何通过其他运动方式（如北欧步行和吸气肌训练）提高依从性，同时最大限度地减少症状恶化。系统评价注册：CRD42022340966, 07/07/2022， PROSPERO。
期刊介绍：
BMC Musculoskeletal Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of musculoskeletal disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
The scope of the Journal covers research into rheumatic diseases where the primary focus relates specifically to a component(s) of the musculoskeletal system.
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