Evidence-based recommendations for the role of exercise in the management of osteoarthritis of the hip or knee - the MOVE consensus
Evidence-based recommendations for the role of exercise in the management of osteoarthritis of the hip or knee - the MOVE consensus
复制标题
DOI：
10.1093/rheumatology/keh399
复制
发表时间：
2005-01-01
期刊：
影响因子：
5.5
通讯作者：
Richards, S
中科院分区：
文献类型：
--
作者：
Roddy, E;Zhang, W;Richards, S
目标.运动是治疗下肢骨关节炎（OA）的有效且常用的干预措施。然而，关于运动疗法的实际实施，仍然存在许多悬而未决的问题。我们已经提出了循证建议，以指导医疗保健从业人员。一个多学科指南制定小组由与开放式办公有关的专业机构和其他有关方面的代表组成。每名参与者贡献了10个命题，描述了髋关节或膝关节OA运动疗法的关键临床要点。德尔菲法最终提出了10条建议。每个人的研究证据都被确定了。在Medline、PubMed、EMBASE、PEDro、CINAHL和科克伦数据库中进行文献检索。对检索到的每篇出版物的方法学质量进行了评估。结果数据进行了提取和效应量计算。对每个建议的证据进行评估，并通过两个类别的分配突出专家共识：（1）证据强度和（2）解释强度。第一轮的德尔菲过程产生了123个命题。在四个回合后，这一数字减少到10。这些与有氧运动和强化运动、团体与家庭运动、依从性、禁忌症和反应预测因素有关。文献检索识别出910篇文章; 57项干预试验与膝关节OA相关，9项与髋关节OA相关，73项与依从性相关。最后给出了支持每一命题的证据。这些是髋关节和膝关节OA运动的第一个建议，以明确区分研究证据和专家意见。在文献中的差距被确定和需要进一步研究的问题突出。
Objectives. Exercise is an effective and commonly prescribed intervention for lower limb osteoarthritis (OA). Many unanswered questions remain, however, concerning the practical delivery of exercise therapy. We have produced evidence-based recommendations to guide health-care practitioners.Methods. A multidisciplinary guideline development group was formed from representatives of professional bodies to which OA is of relevance and other interested parties. Each participant contributed up to 10 propositions describing key clinical points regarding exercise therapy for OA of the hip or knee. Ten final recommendations were agreed by the Delphi technique. The research evidence for each was determined. A literature search was undertaken in the Medline, PubMed, EMBASE, PEDro, CINAHL and Cochrane databases. The methodological quality of each retrieved publication was assessed. Outcome data were abstracted and effect sizes calculated. The evidence for each recommendation was assessed and expert consensus highlighted by the allocation of two categories: (1) strength of evidence and (2) strength of recommendation.Results. The first round of the Delphi process produced 123 propositions. This was reduced to 10 after four rounds. These related to aerobic and strengthening exercise, group versus home exercise, adherence, contraindications and predictors of response. The literature search identified 910 articles; 57 intervention trials relating to knee OA, 9 to hip OA and 73 to adherence. The evidence to support each proposition is presented.Conclusion. These are the first recommendations for exercise in hip and knee OA to clearly differentiate research evidence and expert opinion. Gaps in the literature are identified and issues requiring further study highlighted.