Belinda J Lawford, Rana S Hinman, Libby Spiers, Alexander J Kimp, Andrea Dell'Isola, Alison R Harmer, Martin Van der Esch, Michelle Hall, Kim L Bennell
{"title":"更严格遵守美国运动医学会运动处方指南是否会影响膝关节骨性关节炎的运动效果？系统回顾与荟萃分析。","authors":"Belinda J Lawford, Rana S Hinman, Libby Spiers, Alexander J Kimp, Andrea Dell'Isola, Alison R Harmer, Martin Van der Esch, Michelle Hall, Kim L Bennell","doi":"10.1002/acr.25451","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>We wanted to determine if higher compliance with American College of Sports Medicine (ACSM) exercise prescription guidelines influences exercise outcomes in knee osteoarthritis (OA).</p><p><strong>Methods: </strong>We conducted a systematic review. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase up to January 4, 2024, for randomized controlled trials evaluating resistance and/or aerobic exercise for knee OA. Interventions were classified as higher compliance (meeting ≥60% of ACSM guideline recommendations for frequency, intensity, and duration) or lower compliance (meeting <60% of recommendations). Effects on pain and function were evaluated via meta-analysis, stratified by compliance.</p><p><strong>Results: </strong>Twenty-five trials (3,290 participants) evaluated combined resistance and aerobic programs, with no differences in outcomes between those with higher and lower compliance (standardized mean difference [SMD] pain: -0.38 [95% confidence interval (CI) -0.59 to -0.17] vs -0.31 [95% CI -0.45 to -0.16], respectively; SMD function: -0.43 [95% CI -0.64 to -0.21] vs -0.36 [95% CI -0.58 to -0.14]). Sixty-six trials (5,231 participants) evaluated resistance exercise, with no differences between interventions with higher and lower compliance (SMD pain: -0.60 [95% CI -0.81 to -0.39] vs -0.93 [95% CI -1.27 to -0.59]; SMD function: -0.64 [95% CI -0.83 to -0.44] vs -0.85 [95% CI -1.20 to -0.49]). Twelve trials (958 participants) evaluated aerobic exercise, with no differences between interventions with higher and lower compliance (SMD pain: -0.79 [95% CI -1.20 to -0.38] vs -1.00 [95% CI -2.52 to 0.53]; SMD function: -0.83 [95% CI -1.27 to -0.38] vs -0.76 [95% CI -2.02 to 0.50]).</p><p><strong>Conclusion: </strong>Higher or lower compliance with ACSM exercise prescription guidelines did not influence exercise outcomes. Given there was substantial heterogeneity and many publications were at risk of bias, our results should be interpreted with caution.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Does Higher Compliance With American College of Sports Medicine Exercise Prescription Guidelines Influence Exercise Outcomes in Knee Osteoarthritis? 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Effects on pain and function were evaluated via meta-analysis, stratified by compliance.</p><p><strong>Results: </strong>Twenty-five trials (3,290 participants) evaluated combined resistance and aerobic programs, with no differences in outcomes between those with higher and lower compliance (standardized mean difference [SMD] pain: -0.38 [95% confidence interval (CI) -0.59 to -0.17] vs -0.31 [95% CI -0.45 to -0.16], respectively; SMD function: -0.43 [95% CI -0.64 to -0.21] vs -0.36 [95% CI -0.58 to -0.14]). Sixty-six trials (5,231 participants) evaluated resistance exercise, with no differences between interventions with higher and lower compliance (SMD pain: -0.60 [95% CI -0.81 to -0.39] vs -0.93 [95% CI -1.27 to -0.59]; SMD function: -0.64 [95% CI -0.83 to -0.44] vs -0.85 [95% CI -1.20 to -0.49]). Twelve trials (958 participants) evaluated aerobic exercise, with no differences between interventions with higher and lower compliance (SMD pain: -0.79 [95% CI -1.20 to -0.38] vs -1.00 [95% CI -2.52 to 0.53]; SMD function: -0.83 [95% CI -1.27 to -0.38] vs -0.76 [95% CI -2.02 to 0.50]).</p><p><strong>Conclusion: </strong>Higher or lower compliance with ACSM exercise prescription guidelines did not influence exercise outcomes. 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引用次数: 0
摘要
目的确定更严格遵守美国运动医学学会（ACSM）运动处方指南是否会影响膝骨关节炎的运动效果：方法：系统回顾。截至 2024 年 1 月 4 日，我们在 Cochrane 对照试验中央注册中心 (CENTRAL)、MEDLINE 和 Embase 中检索了评估膝关节 OA 阻力运动和/或有氧运动的随机对照试验。干预措施被分为较高依从性（在频率、强度和持续时间方面符合 ACSM 指南建议的比例≥60%）或较低依从性（符合 结果：25 项试验（3,290 名参与者）评估了阻力和有氧运动的组合项目，较高依从性和较低依从性之间的结果没有差异（疼痛的标准化平均差 [SMD] ：-0.38[95%置信区间：-0.59至-0.17] vs -0.31 [-0.45至-0.16]；功能：-0.43 [-0.64至-0.21] vs -0.36 [-0.58至-0.14]）。66项试验（5231名参与者）对阻力运动进行了评估，依从性较高和较低的干预措施之间没有差异（疼痛：-0.60 [-0.81 至 -0.39] vs -0.93 [-1.27 至 -0.59]）；功能：-0.64 [-0.83 至 -0.44] vs -0.85 [-1.20 至 -0.49]）。12项试验（958名参与者）对有氧运动进行了评估，结果显示，依从性较高和较低的干预措施之间没有差异（疼痛：-0.83 [-1.27 to -0.38] vs -0.76 [-2.02 to 0.50]；功能：-0.79 [-1.20 to -0.38] vs -1.00 [-2.52 to 0.53]）：结论：对ACSM运动处方指南遵守程度的高低并不会影响运动效果。鉴于存在很大的异质性，且许多出版物存在偏倚风险，因此在解释我们的结果时应谨慎。
Does Higher Compliance With American College of Sports Medicine Exercise Prescription Guidelines Influence Exercise Outcomes in Knee Osteoarthritis? A Systematic Review With Meta-Analysis.
Objective: We wanted to determine if higher compliance with American College of Sports Medicine (ACSM) exercise prescription guidelines influences exercise outcomes in knee osteoarthritis (OA).
Methods: We conducted a systematic review. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase up to January 4, 2024, for randomized controlled trials evaluating resistance and/or aerobic exercise for knee OA. Interventions were classified as higher compliance (meeting ≥60% of ACSM guideline recommendations for frequency, intensity, and duration) or lower compliance (meeting <60% of recommendations). Effects on pain and function were evaluated via meta-analysis, stratified by compliance.
Results: Twenty-five trials (3,290 participants) evaluated combined resistance and aerobic programs, with no differences in outcomes between those with higher and lower compliance (standardized mean difference [SMD] pain: -0.38 [95% confidence interval (CI) -0.59 to -0.17] vs -0.31 [95% CI -0.45 to -0.16], respectively; SMD function: -0.43 [95% CI -0.64 to -0.21] vs -0.36 [95% CI -0.58 to -0.14]). Sixty-six trials (5,231 participants) evaluated resistance exercise, with no differences between interventions with higher and lower compliance (SMD pain: -0.60 [95% CI -0.81 to -0.39] vs -0.93 [95% CI -1.27 to -0.59]; SMD function: -0.64 [95% CI -0.83 to -0.44] vs -0.85 [95% CI -1.20 to -0.49]). Twelve trials (958 participants) evaluated aerobic exercise, with no differences between interventions with higher and lower compliance (SMD pain: -0.79 [95% CI -1.20 to -0.38] vs -1.00 [95% CI -2.52 to 0.53]; SMD function: -0.83 [95% CI -1.27 to -0.38] vs -0.76 [95% CI -2.02 to 0.50]).
Conclusion: Higher or lower compliance with ACSM exercise prescription guidelines did not influence exercise outcomes. Given there was substantial heterogeneity and many publications were at risk of bias, our results should be interpreted with caution.
期刊介绍：
Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.
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