{"title":"Dose-Response Relationships of Resistance Training in Adults With Knee Osteoarthritis: A Systematic Review and Meta-analysis.","authors":"Huan Wang, Baoan Ma, Guotuan Wang, Pu Wang, Hua Long, Shun Niu, Chuan Dong, Hongtao Zhang, Zhen Zhao, Qiong Ma, Chihw-Wen Hsu, Yong Yang, Jianshe Wei","doi":"10.1519/JPT.0000000000000394","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and purpose: </strong>To determine the effects of resistance training (RT) on symptoms, function, and lower limb muscle strength in patients with knee osteoarthritis (KOA), and to determine the optimal dose-response relationships.</p><p><strong>Data sources: </strong>We searched the PubMed, MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and ClinicalTrials.gov databases from inception to January 23, 2022.</p><p><strong>Eligibility criteria: </strong>Randomized controlled trials that examined the effects of RT in KOA patients (mean age ≥50 years) were included.</p><p><strong>Data synthesis: </strong>We applied Hedges' g of the random-effects model to calculate the between-subject standardized mean difference (SMDbs). A random-effects metaregression was calculated to explain the influence of key training variables on the effectiveness of RT. We used the Grading of Recommendations Assessments, Development and Evaluation (GRADE) method to appraise the certainty of evidence.</p><p><strong>Results: </strong>A total of 46 studies with 4289 participants were included. The analysis revealed moderate effects of RT on symptoms and function (SMDbs =-0.52; 95% CI: -0.64 to -0.40), and lower limb muscle strength (SMDbs = 0.53; 95% CI: 0.42 to 0.64) in the intervention group compared with the control group. The results of the metaregression revealed that only the variable \"training period\" (P< .001) had significant effects on symptoms, function, and lower limb muscle strength, and the 4 to 8 weeks of training subgroup showed greater effects than other subgroups (SMDbs =-0.70, -0.91 to -0.48; SMDbs = 0.76, 0.56 to 0.96).</p><p><strong>Conclusions: </strong>Compared with inactive treatments, RT is strongly recommended to improve symptoms, function, and muscle strength in individuals with KOA. Dose-response relationship analysis showed that 4 to 8 weeks of RT had more benefits.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":" ","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Geriatric Physical Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1519/JPT.0000000000000394","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background and purpose: To determine the effects of resistance training (RT) on symptoms, function, and lower limb muscle strength in patients with knee osteoarthritis (KOA), and to determine the optimal dose-response relationships.
Data sources: We searched the PubMed, MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and ClinicalTrials.gov databases from inception to January 23, 2022.
Eligibility criteria: Randomized controlled trials that examined the effects of RT in KOA patients (mean age ≥50 years) were included.
Data synthesis: We applied Hedges' g of the random-effects model to calculate the between-subject standardized mean difference (SMDbs). A random-effects metaregression was calculated to explain the influence of key training variables on the effectiveness of RT. We used the Grading of Recommendations Assessments, Development and Evaluation (GRADE) method to appraise the certainty of evidence.
Results: A total of 46 studies with 4289 participants were included. The analysis revealed moderate effects of RT on symptoms and function (SMDbs =-0.52; 95% CI: -0.64 to -0.40), and lower limb muscle strength (SMDbs = 0.53; 95% CI: 0.42 to 0.64) in the intervention group compared with the control group. The results of the metaregression revealed that only the variable "training period" (P< .001) had significant effects on symptoms, function, and lower limb muscle strength, and the 4 to 8 weeks of training subgroup showed greater effects than other subgroups (SMDbs =-0.70, -0.91 to -0.48; SMDbs = 0.76, 0.56 to 0.96).
Conclusions: Compared with inactive treatments, RT is strongly recommended to improve symptoms, function, and muscle strength in individuals with KOA. Dose-response relationship analysis showed that 4 to 8 weeks of RT had more benefits.
背景和目的：确定阻力训练（RT）对膝骨关节炎（KOA）患者症状、功能和下肢肌力的影响，并确定最佳的剂量-反应关系。数据来源：从开始到2022年1月23日，我们搜索了PubMed、MEDLINE、Embase、Cochrane Central Register of Controlled Trials（Central）、Web of Science和ClinicalTrials.gov数据库。合格标准：包括检查RT对KOA患者（平均年龄≥50岁）影响的随机对照试验。数据综合：我们应用随机效应模型的Hedges’g来计算受试者之间的标准化平均差（SMDbs）。计算随机效应元回归来解释关键训练变量对RT有效性的影响。我们使用建议分级评估、发展和评估（GRADE）方法来评估证据的确定性。结果：共纳入46项研究，参与者4289人。分析显示，与对照组相比，RT对干预组的症状和功能（SMDbs=0.52；95%CI:0.64至-0.40）以及下肢肌力（SMDbs=0.53；95%CI:0.42至0.64）有中度影响。多元回归结果显示，只有可变的“训练期”（P<.001）对症状、功能和下肢肌肉力量有显著影响，4至8周的训练亚组比其他亚组表现出更大的影响（SMDbs=0.70，-0.91至-0.48；SMDbs=7.76，0.56至0.96），强烈建议RT改善KOA患者的症状、功能和肌肉力量。剂量-反应关系分析显示，4至8周的RT有更多的益处。
期刊介绍：
Journal of Geriatric Physical Therapy is the leading source of clinically applicable evidence for achieving optimal health, wellness, mobility, and physical function across the continuum of health status for the aging adult.
The mission of the Academy of Geriatric Physical Therapy is building a community that advances the profession of physical therapy to optimize the experience of aging.
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