The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part two: strengthening exercise programs

被引：172

作者：

Brosseau, Lucie ^{[1
]}

Taki, Jade ^{[2
]}

Desjardins, Brigit ^{[3
]}

Thevenot, Odette ^{[3
]}

Fransen, Marlene ^{[4
]}

Wells, George A. ^{[5
]}

Imoto, Aline Mizusaki ^{[6
]}

Toupin-April, Karine ^{[7
]}

Westby, Marie ^{[8
]}

Alvarez Gallardo, Inmaculada C. ^{[9
]}

Gifford, Wendy ^{[10
]}

Laferriere, Lucie ^{[11
]}

Rahman, Prinon ^{[12
]}

Loew, Laurianne ^{[13
]}

De Angelis, Gino ^{[13
]}

Cavallo, Sabrina ^{[13
]}

Shallwani, Shirin Mehdi ^{[13
]}

Aburub, Ala' ^{[13
]}

Bennell, Kim L. ^{[14
]}

Van der Esch, Martin ^{[15
,16
,17
]}

Simic, Milena ^{[18
]}

McConnell, Sara ^{[19
]}

Harmer, Alison ^{[20
]}

Kenny, Glen P. ^{[21
]}

Paterson, Gail ^{[22
]}

Regnaux, Jean-Philippe ^{[23
]}

Lefevre-Colau, Marie-Martine ^{[24
]}

McLean, Linda ^{[25
]}

机构：

[1] Univ Ottawa, Physiotherapy Program, Ottawa, ON, Canada

[2] Univ Ottawa, Interdisciplinary Sch Hlth Sci, Ottawa, ON, Canada

[3] Univ Ottawa, Sch Human Kinet, Ottawa, ON, Canada

[4] Univ Sydney, Fac Hlth Sci, Sydney, NSW, Australia

[5] Univ Ottawa, Sch Epidemiol, Ottawa, ON, Canada

[6] UNIFESP, Internal Med, Brasilia, DF, Brazil

[7] Univ Ottawa, Res Inst, Childrens Hosp Eastern Ontario, Ottawa, ON, Canada

[8] Univ British Columbia, Vancouver, BC, Canada

[9] Univ Granada, Dept Phys Educ & Sport, Granada, Spain

[10] Univ Ottawa, Sch Nursing, Ottawa, ON, Canada

[11] Canadian Forces Hlth Serv Grp Headquarters, Natl Def, Ottawa, ON, Canada

[12] Dalhousie Univ, Dept Community Hlth & Epidemiol, Halifax, NS, Canada

[13] Univ Ottawa, Sch Rehabil Sci, Ottawa, ON, Canada

[14] Univ Melbourne, Sch Hlth Sci, Dept Physiotherapy, Melbourne, Vic, Australia

[15] Reade Ctr Rehabil & Rheumatol, Dept Rehabil, Amsterdam, Netherlands

[16] Univ Appl Sci, Fac Hlth, ACHIEVE, Ctr Appl Res, Amsterdam, Netherlands

[17] Univ Appl Sci, Sch Physiotherapy, Amsterdam, Netherlands

[18] Univ Sydney, Discipline Physiotherapy, Fac Hlth Sci, Lidcombe, Australia

[19] St Josephs Hlth Care Ctr, Dept Med, Toronto, ON, Canada

[20] Univ Sydney, Clin & Rehabil Sci Res Grp, Fac Hlth Sci, Sydney, NSW, Australia

[21] Univ Ottawa, Sch Human Kinet, Fac Hlth Sci, Ottawa, ON, Canada

[22] Arthrit Soc, Ottawa Off, Ontario Div, Ottawa, ON, Canada

[23] Hop Hotel Dieu, Ctr Rech Epidemiol & Biostat, Paris, France

[24] Cochin Hosp, Dept Med & Rehabil, Inst Rheumatol, Paris, France

[25] Univ Ottawa, Sch Rehabil Sci, Fac Hlth Sci, Physiotherapy Program, Ottawa, ON, Canada

来源：

CLINICAL REHABILITATION | 2017年 / 31卷 / 05期

关键词：

Therapeutic exercise; strengthening exercises; knee osteoarthritis; clinical practice guideline; systematic review; RANDOMIZED CONTROLLED-TRIAL; HOME-BASED EXERCISE; QUALITY-OF-LIFE; OLDER-ADULTS; RESISTANCE EXERCISE; PHYSICAL-ACTIVITY; THERAPEUTIC EXERCISES; EDUCATION-PROGRAM; AEROBIC EXERCISE; SELF-MANAGEMENT;

D O I：

10.1177/0269215517691084

中图分类号：

R49 [康复医学];

学科分类号：

100232 [康复医学];

摘要：

Objective: To identify effective strengthening exercise programs and provide rehabilitation teams and patients with updated, high-quality recommendations concerning traditional land-based exercises for knee osteoarthritis. Methods: A systematic search and adapted selection criteria included comparative controlled trials with strengthening exercise programs for patients with knee osteoarthritis. A panel of experts reached consensus on the recommendations using a Delphi survey. A hierarchical alphabetical grading system (A, B, C+, C, D, D+ or D-) was based on statistical significance (p<0.5) and clinical importance (15% improvement). Results: The 26 high-quality studies identified demonstrated that various strengthening exercise programs with/without other types of therapeutic exercises are generally effective for improving knee osteoarthritis management within a six-month period. Strengthening exercise programs demonstrated a significant improvement for pain relief (four Grade A, ten Grade B, two Grade C+), physical function (four Grade A, eight Grade B) and quality of life (three Grade B). Strengthening in combination with other types of exercises (coordination, balance, functional) showed a significant improvement in pain relief (three Grade A, 11 Grade B, eight Grade C+), physical function (two Grade A, four Grade B, three Grade C+) and quality of life (one Grade A, one Grade C+). Conclusion: There are a variety of choices for strengthening exercise programs with positive recommendations for healthcare professionals and knee osteoarthritis patients. There is a need to develop combined behavioral and muscle-strengthening strategies to improve long-term maintenance of regular strengthening exercise programs.

引用

页码：596 / 611

页数：16

共 92 条

[31]

Association of Exercise Therapy and Reduction of Pain Sensitivity in Patients With Knee Osteoarthritis: A Randomized Controlled Trial [J].