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中华关节外科杂志(电子版) ›› 2024, Vol. 18 ›› Issue (02) : 264 -270. doi: 10.3877/cma.j.issn.1674-134X.2024.02.015

综述

膝关节骨关节炎的运动学疗法
郝鑫1, 贾健2, 任雨昊3, 成凯2, 王小虎4,()   
  1. 1. 030000 太原,山西医科大学;041000 临汾市人民医院
    2. 041000 临汾市人民医院
    3. 030000 太原,山西医科大学
    4. 030000 太原,山西医科大学第二医院
  • 收稿日期:2023-12-04 出版日期:2024-04-01
  • 通信作者: 王小虎
  • 基金资助:
    山西省卫生健康委员会"四个一批"创新计划(2020TD18); 山西省自然科学基金(20210302123298)

Exercise therapy for knee osteoarthritis

Xin Hao1, Jian Jia2, Yuhao Ren3, Kai Cheng2, Xiaohu Wang4,()   

  1. 1. Shanxi Medical Universit, Taiyuan 030000, China; Linfen People′s Hospital, Linfen 041000, China
    2. Linfen People′s Hospital, Linfen 041000, China
    3. Shanxi Medical Universit, Taiyuan 030000, China
    4. Second Hospital of Shanxi Medical Universit, Taiyuan 030000, China
  • Received:2023-12-04 Published:2024-04-01
  • Corresponding author: Xiaohu Wang
引用本文:

郝鑫, 贾健, 任雨昊, 成凯, 王小虎. 膝关节骨关节炎的运动学疗法[J]. 中华关节外科杂志(电子版), 2024, 18(02): 264-270.

Xin Hao, Jian Jia, Yuhao Ren, Kai Cheng, Xiaohu Wang. Exercise therapy for knee osteoarthritis[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2024, 18(02): 264-270.

膝关节骨关节炎(KOA)的运动学疗法是一种非药物治疗方法,旨在通过特定的运动和锻炼来改善症状和功能。这种疗法结合了运动医学和康复原理,针对KOA的特点进行定制,旨在增加关节的稳定性、改善肌肉力量和耐力、提升关节的活动范围、减轻疼痛和改善日常功能。然而,KOA运动学疗法的临床效果尚不明确,且缺少统一的治疗标准。为此,笔者就KOA运动学疗法的概述、具体应用和前景展望等方面的研究进展进行综述,为KOA运动学疗法提供一些新思路。

Exercise therapy for knee osteoarthritis (KOA) is a non-pharmacological treatment approach aimed at improving symptoms and function through specific exercises and physical activities. This therapy integrates principles from sports science and rehabilitation and is tailored to address the unique characteristics of KOA. The goals of exercise therapy include enhancing joint stability, improving muscle strength and endurance, increasing range of motion, alleviating pain, and enhancing daily functionality. However, the clinical efficacy of exercise therapy for KOA remains uncertain, and there is a lack of standardized treatment guidelines. Therefore, this review provided an overview of the research progress in exercise therapy for KOA, including its application and effectiveness evaluation, and proposed new perspectives for the advancement of exercise therapy for KOA.

[13]
Maniar N, Cole MH, Bryant AL, et al. Muscle force contributions to anterior cruciate ligament loading[J]. Sports Med, 2022, 52(8): 1737-1750.
[14]
Zhao Z, Wang R, Guo Y, et al. Static low-angle squatting reduces the intra-articular inflammatory cytokines and improves the performance of patients with knee osteoarthritis[J/OL]. Biomed Res Int, 2019, 2019: 9617923. DOI: 10.1155/2019/9617923.
[15]
Puts S, Liberman K, Leysen L, et al. Exercise-induced effects on inflammatory markers and brain-derived neurotrophic factor in patients with knee osteoarthritis. A systematic review with meta-analysis[J]. Exerc Immunol Rev, 2023, 29: 22-53.
[16]
Kılıçaslan Genç A, Tuncer S. Central sensitization in osteoarthritic knee pain: a cross-sectional study[J]. Turk J Phys Med Rehabil, 2022, 69(1): 89-96.
[17]
Jiang Y, Angeletti PC, Hoffman AJ. Investigating the physiological mechanisms between resistance training and pain relief in the cancer population: aliterature review[J]. J Cancer Ther, 2023, 14(2): 80-101.
[18]
WHO Guidelines Approved by the Guidelines Review Committee//Global recommendations on physical activity for health[DB/OL]. Geneva: World Health Organization,2010[2023-12-04]. PMID: 26180873.

URL    
[19]
Sakamoto J, Miyahara S, Motokawa S, et al. Regular walking exercise prior to knee osteoarthritis reduces joint pain in an animal model[J/OL]. PLoS One, 2023, 18(8): e0289765. DOI: 10.1371/journal.pone.0289765.
[20]
Klinedinst NJ, Huang W, Nelson AK, et al. Protein changes after 6 weeks of walking and the relationship to pain in adults with knee osteoarthritis[J]. Biol Res Nurs, 2023, 25(1): 65-75.
[21]
Lo GH, Vinod S, Richard MJ, et al. Association between walking for exercise and symptomatic and structural progression in individuals with knee osteoarthritis: data from the osteoarthritis initiative cohort[J]. Arthritis Rheumatol, 2022, 74(10): 1660-1667.
[22]
Master H, Thoma LM, Neogi T, et al. Daily walking and the risk of knee replacement over 5 years among adults with advanced knee osteoarthritis in the United States[J]. Arch Phys Med Rehabil, 2021, 102(10): 1888-1894.
[23]
Lo GH, Ikpeama UE, Driban JB, et al. Evidence that swimming may be protective of knee osteoarthritis: data from the osteoarthritis initiative[J]. PM R, 2020, 12(6): 529-537.
[24]
Qian J, Zhao P, Xu Q, et al. Swimming prevents cell death of chondrocytes via PI3K/AKT pathway in an experimental model[J/OL]. J Orthop Surg Res, 2023, 18(1): 439. DOI: 10.1186/s13018-023-03815-4.
[25]
Xu Z, Wang Y, Zhang Y, et al. Efficacy and safety of aquatic exercise in knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials[J]. Clin Rehabil, 2023, 37(3): 330-347.
[26]
Duan X, Wei W, Zhou P, et al. Effectiveness of aquatic exercise in lower limb osteoarthritis: a meta-analysis of randomized controlled trials[J]. Int J Rehabil Res, 2022, 45(2): 126-136.
[27]
Onigbinde AT, Ajiboye RA, Bada AI, et al. Inter-limb effects of isometric quadriceps strengthening on untrained contra-lateral homologous muscle of patients with knee osteoarthritis[J]. Technol Health Care, 2017, 25(1): 19-27.
[28]
Lai Z, Lee S, Chen Y, et al. Comparison of whole-body vibration training and quadriceps strength training on physical function and neuromuscular function of individuals with knee osteoarthritis: a randomised clinical trial[J]. J Exerc Sci Fit, 2021, 19(3): 150-157.
[29]
Messier SP, Mihalko SL, Beavers DP, et al. Effect of high-intensity strength training on knee pain and knee joint compressive forces among adults with knee osteoarthritis: the START randomized clinical trial[J]. JAMA, 2021, 325(7): 646-657.
[30]
Bennell KL, Schwartz S, Teo PL, et al. Effectiveness of an unsupervised online Yogaprogram on pain and function in people with knee osteoarthritis: arandomized clinical trial[J]. Ann Intern Med, 2022, 175(10): 1345-1355.
[31]
Song J, Wei L, Cheng K, et al. The effect of modified Tai Chi exercises on the physical function and quality of life in elderly women with knee osteoarthritis[J/OL]. Front Aging Neurosci, 2022, 14: 860762. DOI: 10.3389/fnagi.2022.860762.
[32]
张旻,陈博,潘富伟,等. 太极拳对早期膝骨关节炎患者膝关节内侧间室应力的影响[J]. 中国中医骨伤科杂志2022, 30(4): 5-9.
[33]
Brenneman EC, Kuntz AB, Wiebenga EG, et al. A Yogastrengthening program designed to minimize the knee adduction moment for women with knee osteoarthritis: aproof-of-principle cohort study[J/OL]. PLoS One, 2015, 10(9): e0136854. DOI: 10.1371/journal.pone.0136854.
[34]
Luan L, Bousie J, Pranata A, et al. Stationary cycling exercise for knee osteoarthritis: a systematic review and meta-analysis[J]. Clin Rehabil, 2021, 35(4): 522-533.
[35]
Wang Y, Wu Z, Chen Z, et al. Proprioceptive training for knee osteoarthritis: asystematic review and meta-analysis of randomized controlled trials[J/OL]. Front Med, 2021, 8: 699921. DOI: 10.3389/fmed.2021.699921.
[36]
van Doormaal MCM, Meerhoff GA, Vliet Vlieland TPM, et al. A clinical practice guideline for physical therapy in patients with hip or knee osteoarthritis[J]. Musculoskeletal Care, 2020, 18(4): 575-595.
[37]
Shavazipour B, Afsar B, Multanen J, et al. Interactive multiobjective optimization for finding the most preferred exercise therapy modality in knee osteoarthritis[J]. Ann Med, 2022, 54(1): 181-194.
[38]
Abbott JH. Delivering exercise therapy in practice: a lot to consider, and much still to work out[J]. Osteoarthritis Cartilage, 2023, 31(3): 292-294.
[39]
Pedersen JR, Sari DM, Juhl CB, et al. Variability in effect sizes of exercise therapy for knee osteoarthritis depending on comparator interventions[J/OL]. Ann Phys Rehabil Med, 2023, 66(4): 101708. DOI: 10.1016/j.rehab.2022.101708.
[40]
Liao CD, Liao YH, Liou TH, et al. Effects of protein-rich nutritional composition supplementation on sarcopenia indices and physical activity during resistance exercise training in older women with knee osteoarthritis[J/OL]. Nutrients, 2021, 13(8): 2487. DOI: 10.3390/nu13082487.
[41]
Wang J, Liu W, Fu H. Effects of traditional Chinese herb hot compress combined with therapeutic exercise on pain, proprioception, and functional performance among older adults with knee osteoarthritis: a randomized controlled trial[J/OL]. Front Physiol, 2022, 13: 1070754. DOI: 10.3389/fphys.2022.1070754.
[42]
Park S, Min S, Park SH, et al. Influence of isometric exercise combined with electromyostimulation on inflammatory cytokine levels, muscle strength, and knee joint function in elderly women with early knee osteoarthritis[J/OL]. Front Physiol, 2021, 12: 688260. DOI: 10.3389/fphys.2021.688260.
[43]
Stausholm MB, Naterstad IF, Alfredo PP, et al. Short- and long-term effectiveness of low-level laser therapy combined with strength training in knee osteoarthritis: arandomized placebo-controlled trial[J/OL]. J Clin Med, 2022, 11(12): 3446. DOI: 10.3390/jcm11123446.
[44]
Wei S, Wu Z. The application of wearable sensors and machine learning algorithms in rehabilitation training: asystematic review[J/OL]. Sensors, 2023, 23(18): 7667. DOI: 10.3390/s23187667.
[45]
Tan JS, Tippaya S, Binnie T, et al. Predicting knee joint kinematics from wearable sensor data in people with knee osteoarthritis and clinical considerations for future machine learning models[J/OL]. Sensors, 2022, 22(2): 446. DOI: 10.3390/s22020446.
[46]
Wang S, Chan PPK, Lam BMF, et al. Sensor-based gait retraining lowers knee adduction moment and improves symptoms in patients with knee osteoarthritis: arandomized controlled trial[J/OL]. Sensors, 2021, 21(16): 5596. DOI: 10.3390/s21165596.
[47]
Bennell KL, Lawford BJ, Keating C, et al. Comparing video-based, telehealth-delivered exercise and weight loss programs with online education on outcomes of knee osteoarthritis: arandomized trial[J]. Ann Intern Med, 2022, 175(2): 198-209.
[48]
Harris A, Hinman RS, Lawford BJ, et al. Cost-effectiveness of telehealth-delivered exercise and dietary weight loss programs for knee osteoarthritis within a twelve-month randomized trial[J]. Arthritis Care Res, 2023, 75(6): 1311-1319.
[49]
Slomski A. Online exercise plus text messages improve knee osteoarthritis[J/OL]. JAMA, 2021, 325(24): 2427. DOI: 10.1001/jama.2021.8750.
[1]
Cui A, Li H, Wang D, et al. Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies[J/OL]. E Clinical Medicine, 2020, 29-30: 100587. DOI: 10.1016/j.eclinm.2020.100587.
[2]
Bruyère O, Honvo G, Veronese N, et al. An updated algorithm recommendation for the management of knee osteoarthritis from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO)[J]. Semin Arthritis Rheum, 2019, 49(3): 337-350.
[3]
中华医学会骨科学分会关节外科学组. 骨关节炎诊疗指南(2018年版)[J]. 中华骨科杂志2018, 38(12): 705-715.
[4]
中华医学会骨科分会关节外科学组,吴阶平医学基金会骨科学专家委员会. 膝骨关节炎阶梯治疗专家共识(2018年版)[J/CD]. 中华关节外科杂志(电子版), 2019, 13(1): 124-130.
[5]
Arden NK, Perry TA, Bannuru RR, et al. Non-surgical management of knee osteoarthritis: comparison of ESCEO and OARSI 2019 guidelines[J]. Nat Rev Rheumatol, 2021, 17(1): 59-66.
[6]
Torstensen TA, Østerås H, LoMartire R, et al. High- versus low-dose exercise therapy for knee osteoarthritis: arandomized controlled multicenter trial[J]. Ann Intern Med, 2023, 176(2): 154-165.
[7]
Lorås H, Østerås B, Torstensen TA, et al. Medical exercise therapy for treating musculoskeletal pain: anarrative review of results from randomized controlled trials with a theoretical perspective[J]. Physiother Res Int, 2015, 20(3): 182-190.
[8]
Bannuru RR, Osani MC, Vaysbrot EE, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis[J]. Osteoarthritis Cartilage, 2019, 27(11): 1578-1589.
[9]
de Sousa EB, Casado PL, Moura Neto V, et al. Synovial fluid and synovial membrane mesenchymal stem cells: latest discoveries and therapeutic perspectives[J/OL]. Stem Cell Res Ther, 2014, 5(5): 112. DOI: 10.1186/scrt501.
[10]
Gangi LR, Petersen CA, Oungoulian SR, et al. A friction testing-bioreactor device for study of synovial joint biomechanics, mechanobiology, and physical regulation[J/OL]. J Vis Exp, 2022(184): 10.3791/63880. . DOI: 10.3791/63880.
[11]
Hahn AK, Rawle RA, Bothner B, et al. In vivo mechanotransduction: effect of acute exercise on the metabolomic profiles of mouse synovial fluid[J/OL]. Osteoarthr Cartil Open, 2022, 4(1): 100228. DOI: 10.1016/j.ocarto.2021.100228.
[12]
Øiestad BE, Årøen A, Røtterud JH, et al. The efficacy of strength or aerobic exercise on quality of life and knee function in patients with knee osteoarthritis. A multi-arm randomized controlled trial with 1-year follow-up[J/OL]. BMC Musculoskelet Disord, 2023, 24(1): 714. DOI: 10.1186/s12891-023-06831-x.
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