Ottawa Panel Evidence-Based Clinical Practice Guidelines for Aerobic Walking Programs in the Management of Osteoarthritis

被引:79
作者
Loew, Laurianne [1 ]
Brosseau, Lucie [1 ,3 ]
Wells, George A. [3 ,4 ,5 ]
Tugwell, Peter [3 ,4 ,6 ]
Kenny, Glen P. [2 ]
Reid, Robert [5 ]
Maetzel, Andreas [7 ]
Huijbregts, Maria [7 ]
McCullough, Carolyn [7 ,8 ]
De Angelis, Gino [1 ,3 ]
Coyle, Douglas [3 ,4 ]
Panel, Ottawa
机构
[1] Univ Ottawa, Fac Hlth Sci, Sch Rehabil Sci, Ottawa, ON, Canada
[2] Univ Ottawa, Sch Human Kinet, Fac Hlth Sci, Ottawa, ON, Canada
[3] Univ Ottawa, Dept Epidemiol & Community Med, Ottawa, ON, Canada
[4] Ottawa Hosp, Clin Epidemiol Unit, Res Inst, Ottawa, ON, Canada
[5] Univ Ottawa, Inst Heart, Ottawa, ON, Canada
[6] Ctr Global Hlth, Inst Populat Hlth, Ottawa, ON, Canada
[7] Univ Toronto, Toronto, ON, Canada
[8] Interact Rehabil Inc, Toronto, ON, Canada
来源
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION | 2012年 / 93卷 / 07期
关键词
Exercise; Knee; Osteoarthritis; Practice guidelines as topic; Rehabilitation; Review [publication type; Rheumatology; Walking; KNEE ADDUCTION MOMENT; OBESE OLDER-ADULTS; SUPERVISED FITNESS WALKING; QUALITY-OF-LIFE; WEIGHT-LOSS; RHEUMATOID-ARTHRITIS; EXERCISE THERAPY; PHYSICAL-ACTIVITY; FUNCTIONAL PERFORMANCE; MUSCLE STRENGTH;
D O I
10.1016/j.apmr.2012.01.024
中图分类号
R49 [康复医学];
学科分类号
100232 [康复医学];
摘要
Loew L, Brosseau L, Wells GA, Tugwell P, Kenny GP, Reid R, Maetzel A, Huijbregts M, McCullough C, De Angelis G, Coyle D, and the Ottawa Panel. Ottawa Panel evidence-based clinical practice guidelines for aerobic walking programs in the management of osteoarthritis. Arch Phys Med Rehabil 2012;93:1269-85. Objective: To update the Evidence-Based Clinical Practice Guidelines (EBCPGs) on aerobic walking programs for the management of osteoarthritis (OA) of the knee. Data Sources: A literature search was conducted using the electronic databases MEDLINE, Pub Med, and the Cochrane Library for all studies related to aerobic walking programs for OA from 1966 until February 2011. Study Selection: The literature search found 719 potential records, and 10 full-text articles were included according to the selection criteria. The Ottawa Methods Group established the inclusion and exclusion criteria regarding the characteristics of the population, by selecting adults of 40 years old and older who were diagnosed with OA of the knee. Data Extraction: Two reviewers independently extracted important information from each selected study using standardized data extraction forms, such as the interventions, comparisons, outcomes, time period of the effect measured, and study design. The statistical analysis was reported using the Cochrane collaboration methods. An improvement of 15% or more relative to a control group contributes to the achievement of a statistically significant and clinically relevant progress. A specific grading system for recommendations, created by the Ottawa Panel, used a level system (level I for randomized controlled studies and level II for nonrandomized articles). The strength of the evidence of the recommendations was graded using a system with letters: A, B, C+, C, D, D+, or D-. Data Synthesis: Evidence from 7 high-quality studies demonstrated that facility, hospital, and home-based aerobic walking programs with other therapies are effective interventions in the shorter term for the management of patients with OA to improve stiffness, strength, mobility, and endurance. Conclusions: The greatest improvements were found in pain, quality of life, and functional status (grades A, B, or C+). A common limitation inherent to the EBCPGs is the heterogeneity of studies included with regards to the characteristics of the population, the interventions, the comparators, the outcomes, the period of time, and the study design. It is strongly recommended to use the Cochrane Risk of Bias Summary assessment to evaluate the methodologic quality of the studies and to consider avenues for future research on how aerobic walking programs would be beneficial in the management of OA of the hip.
引用
收藏
页码:1269 / 1285
页数:17
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