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Semin Arthritis Rheu:长期运动疗法对膝关节骨关节炎患者膝关节结构的影响

2018-10-27 xiangting MedSci原创

长期运动疗法并不改变胫股骨的影像学疾病严重程度、软骨形态或滑膜炎/积液,但可能略微增加BML严重程度加重的可能性。

这项研究旨在调查长期运动疗法对膝关节骨关节炎(OA)患者影像学疾病严重程度和软骨完整性(主要结局),以及骨髓病变(BMLs)严重程度、滑膜炎和/或积液(次要结局)的影响。

这是一项随机对照试验,纳入临床性和/或影像学OA患者。与没有运动相比,调查了>6个月的下地运动疗法对影像学疾病严重程度和软骨完整性(形态或组成)以及BML、滑膜炎和/或积液严重程度MRI结果的影响。两名独立评审员提取数据并评估偏倚风险。使用随机效应meta分析汇总标准化平均差(SMD)(95%置信区间(CI))或优势比(OR)(95%CI)和估算异质性(I2,%)。按照GRADE方法对汇总证据的质量进行评级。不适合meta分析的研究在最佳证据综合中进行总结。

meta分析显示,中等质量证据表明对胫股影像学疾病严重程度没有治疗效果((SMD)95%(CI):0.06(-0.07,0.20),I2=0%),低质量证据表明对胫股骨软骨形态没有影响(SMD(95%):0.06(-0.20,0.36),I2=0%)。低质量证据显示对滑膜炎((OR)(95%CI):0.90(0.51,1.60),I2=0%)和积液变化的几率没有治疗效果((OR(95%CI):0.88(0.64,1.20),I2=0%),但胫股骨BMLs恶化的可能性更大(OR(95%CI):1.90(1.11,3.26),I2=0%)。在最佳证据综合中,与不运动相比,少量证据表明轻度膝关节OA女性患者运动后髌软骨组成发生变化,但没有证据表明胫股骨软骨发生变化。

长期运动疗法并不改变胫股骨的影像学疾病严重程度、软骨形态或滑膜炎/积液,但可能略微增加BML严重程度加重的可能性。总体而言,meta分析的发现在直接性和精确性方面受到限制,并仅限于平均肥胖人群相对不精确效果的评价。有限的证据表明对髌骨软骨组成有一定的保护作用。

原始出处:

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    2018-10-29 lmm397
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    2018-10-29 zhaojie88
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