在膝盖或关节骨关节炎患者中减轻疼痛的最佳运动方式和剂量:贝叶斯对对,网络和剂量反应元分析
Zhide Liang1, Chuanzhi Wang2, Meng Zhang3
1Faculty of Health Sciences and Sports, Macao Polytechnic University, Rua de Gomes, Macau, China.
Seminars in arthritis and rheumatism
|October 22, 2025
概括
运动有效地减少膝盖或关节骨关节炎 (OA) 的疼痛. 有氧训练和联合力量/灵活性训练显示出效率最高的可能性,观察到以U形的剂量反应可获得最佳的疼痛缓解.
科学领域:
- 整形外科和体育医学
- 康复科学 康复科学 康复科学
- 疼痛管理 疼痛管理
背景情况:
- 膝关节和关节骨关节炎 (OA) 是慢性疼痛和残疾的常见原因.
- 运动是保守的OA管理的基石,但最佳的方法和剂量仍在争论中.
研究的目的:
- 系统地比较各种运动方式在膝盖或部OA疼痛缓解方面的有效性.
- 为了研究运动和OA患者的疼痛缓解之间的剂量反应关系.
主要方法:
- 系统搜索六个随机对照试验 (RCT) 数据库,直到2024年12月.
- 贝叶斯网络和剂量反应元分析使用随机效应模型进行.
- 包括文献的质量评估由两位独立审稿人进行.
主要成果:
- 对92个RCT (6079名参与者) 的分析表明,有氧训练具有最高的有效率 (SUCRA:84.7%).
- 与灵活性训练 (SUCRA: 73.0%) 和 (SUCRA: 63.7%) 结合的力量训练也显示出高效率的可能性.
- 观察到U形的剂量反应曲线,表明最佳的运动剂量可以缓解疼痛.
结论:
- 运动有效地减少了膝盖或部OA的个人的疼痛.
- 虽然没有单一的模式在统计上优越,有氧,联合力量/灵活性和训练显示出最高的概率有效性.
- 建议每周最佳运动剂量为620METs-min,以获得最大的疼痛缓解,而临床重要性需要180METs-min,尽管由于证据的确定性,研究结果需要谨慎解释.
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