Ottawa Panel Evidence-Based Clinical Practice Guidelines for the Management of Osteoarthritis in Adults Who Are Obese or Overweight

被引：78

作者：

Brosseau, Lucie ^{[1
,2
]}

Wells, George A. ^{[3
,4
]}

Tugwell, Peter ^{[4
,5
]}

Egan, Mary ^{[1
]}

Dubouloz, Claire-Jehanne ^{[1
]}

Casimiro, Lynn ^{[6
]}

Bugnariu, Nicoleta ^{[7
]}

Welch, Vivian A. ^{[5
]}

De Angelis, Gino ^{[1
]}

Francoeur, Lilliane ^{[8
]}

Milne, Sarah ^{[1
,9
]}

Loew, Laurianne ^{[1
]}

McEwan, Jessica ^{[10
]}

Messier, Steven P. ^{[11
]}

Doucet, Eric ^{[12
]}

Kenny, Glen P. ^{[12
]}

Prud'homme, Denis ^{[12
]}

Lineker, Sydney ^{[13
]}

Bell, Mary ^{[14
]}

Poitras, Stephane ^{[1
]}

Li, Jing Xian ^{[12
]}

Finestone, Hillel M. ^{[15
]}

Laferriere, Lucie ^{[16
]}

Haines-Wangda, Angela

Russell-Doreleyers, Marion ^{[13
]}

Lambert, Kim ^{[13
]}

Marshall, Alison D. ^{[1
]}

Cartizzone, Margot ^{[1
]}

Teav, Adam ^{[12
]}

机构：

[1] Univ Ottawa, Sch Rehabil Sci, Fac Hlth Sci, Ottawa, ON K1H 8M5, Canada

[2] Montfort Hosp, Res Inst, Ottawa, ON, Canada

[3] Ottawa Hosp, Clin Epidemiol Program, Res Inst, Ottawa, ON K1H 8L6, Canada

[4] Univ Ottawa, Dept Epidemiol & Community Med, Ottawa, ON K1H 8M5, Canada

[5] Ctr Global Hlth, Inst Populat Hlth, Ottawa, ON, Canada

[6] Montfort Hosp, Dept Acad Affairs, Leicester, Leics, England

[7] Univ N Texas, Phys Therapy Dept, Hlth Sci Ctr, Ft Worth, TX USA

[8] Univ Ottawa, Program Nutr Sci, Fac Hlth Sci, Ottawa, ON K1H 8M5, Canada

[9] Childrens Hosp Eastern Ontario, Physiotherapy Dept, Ottawa, ON K1H 8L1, Canada

[10] Univ Ottawa, Hlth Sci Library, Ottawa, ON K1H 8M5, Canada

[11] Wake Forest Univ, Dept Hlth & Exercise Sci, JB Snow Biomech Lab, Winston Salem, NC 27109 USA

[12] Univ Ottawa, Sch Human Kinet, Fac Hlth Sci, Ottawa, ON K1H 8M5, Canada

[13] Arthrit Soc, Toronto, ON, Canada

[14] Univ Toronto, Toronto, ON M5S 1A1, Canada

[15] Elisabeth Bruyere Hlth Ctr, SCO Hlth Serv, Ottawa, ON, Canada

[16] Canadian Forces Hlth Serv Grp Headquarters, Directorate Force Hlth Protect, Ottawa, ON, Canada

来源：

PHYSICAL THERAPY | 2011年 / 91卷 / 06期

关键词：

IMPROVES PHYSICAL FUNCTION; DIETARY WEIGHT-LOSS; BODY-MASS INDEX; KNEE OSTEOARTHRITIS; OLDER-ADULTS; MUSCULOSKELETAL DISORDERS; NATIONAL-HEALTH; ACUTE EXERCISE; PAIN; ARTHRITIS;

D O I：

10.2522/ptj.20100104

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

100224 [整形外科学];

摘要：

Background and Purpose. The objective of this review was to construct an updated evidence-based clinical practice guideline on the use of physical activity and diet for the management of osteoarthritis (OA) in adults (>18 years of age) who are obese or overweight (body mass index >= 25 kg/m(2)). Data Sources. Articles were extracted from the following databases: MEDLINE, EMBASE (Current Contents), SPORTDiscus, SUM, Scopus, CINAHL, AMED, BIOMED, PubMed, ERIC, the Cochrane Controlled Trials, and PEDro. Study Selection. The Ottawa Panel and research assistance team strictly applied the inclusion and exclusion criteria from previous Ottawa Panel publications. Data Extraction. An a priori literature search was conducted for articles related to obesity and OA of the lower extremities that were published from January 1, 1966, to November 30, 2010. Inclusion criteria and the methods to grade the recommendations were created by the Ottawa Panel. Data Synthesis. Recommendations were graded based on the strength of evidence (A, B, C, C+, D, D+, or D-) as well as experimental design (I for randomized controlled trials and II for nonrandomized studies). In agreement with previous Ottawa Panel methods, Cochrane Collaboration methods were utilized for statistical analysis. Clinical significance was established by an improvement of >= 15% in the experimental group compared with the control group. There were a total of 79 recommendations from 9 articles. From these recommendations, there were 36 positive recommendations: 21 grade A and 15 grade C+. There were no grade B recommendations, and all recommendations were of clinical benefit. Limitations. Further research is needed, as more than half of the trials were of low methodological quality. Conclusions. This review suggests that physical activity and diet programs are beneficial, specifically for pain relief (9 grade A recommendations) and improved functional status (6 grade A and 7 grade C+ recommendations), for adults with OA who are obese or overweight. The Ottawa Panel was able to demonstrate that when comparing physical activity alone, diet alone, physical activity combined with diet, and control groups, the intervention including physical activity and diet produced the most beneficial results.

引用

页码：843 / 861

页数：19

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