Effects of Community-Deliverable Exercise on Pain and Physical Function in Adults With Arthritis and Other Rheumatic Diseases: A Meta-Analysis
Effects of Community-Deliverable Exercise on Pain and Physical Function in Adults With Arthritis and Other Rheumatic Diseases: A Meta-Analysis
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DOI：
10.1002/acr.20347
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发表时间：
2011-01-01
影响因子：
4.7
通讯作者：
Jones, Dina L.
中科院分区：
文献类型：
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作者：
Kelley, George A.;Kelley, Kristi S.;Jones, Dina L.
Objective.采用荟萃分析方法，以确定社区可交付的运动对关节炎和其他风湿性疾病（AORD）成人疼痛和身体功能的影响。数据来源包括6个电子数据库、检索研究的交叉引用和专家审查。研究选择包括1）随机对照试验; 2）>= 1个运动干预组; 3）社区可交付运动干预持续时间>= 4周; 4）对照组; 5）年龄>= 18岁的成人类风湿性关节炎，骨关节炎，纤维肌痛，狼疮，痛风或强直性脊柱炎; 6）已发表和未发表的研究; 7）1980年1月1日至2008年1月1日期间以任何语言发表的研究;以及8）疼痛和/或身体功能的可用数据。数据抽象包括2名作者的双重编码。标准化效应量（g）和随机效应模型用于汇总疼痛和身体功能结局。根据符合方案和意向治疗（ITT）结果分析数据。计算最小临床重要差异（MCID）和需要治疗的人数（NNT）。纳入了33项研究，代表了3，180名患有类风湿性关节炎、骨关节炎和纤维肌痛的男性和女性（1，857名运动，1，323名对照）。观察到疼痛有统计学显著性和临床重要性改善（符合方案g = -0.37 [95%置信区间（95% CI）-0.53，-0.21]，MCID -18%; ITT g = -0.20 [95% CI-0.33，-0.07]，MCID-9%，NNT 9）和身体功能（符合方案g = 0.37 [95% CI 0.21，0.52]，MCID 15%; ITT g = 0.34 [95% CI 0.25，0.43]，MCID 10%，NNT 5）。社区可交付的运动改善了分析中包括的AORD类型的成年人的疼痛和身体功能。需要对其他类型AORD患者进行剂量反应研究和研究。
Objective. To use the meta-analytic approach to determine the effects of community-deliverable exercise on pain and physical function in adults with arthritis and other rheumatic diseases (AORD).Methods. Data sources consisted of 6 electronic databases, cross-referencing from retrieved studies and expert review. Study selection included 1) randomized controlled trials; 2) >= 1 exercise intervention group; 3) community-deliverable exercise interventions >= 4 weeks in duration; 4) control group; 5) adults ages >= 18 years with rheumatoid arthritis, osteoarthritis, fibromyalgia, lupus, gout, or ankylosing spondylitis; 6) published and unpublished studies; 7) studies published in any language between January 1, 1980, and January 1, 2008; and 8) data available for pain and/or physical function. Data abstraction included dual coding by 2 of the authors. Standardized effect sizes (g) and random-effects models were used to pool pain and physical function outcomes. Data were analyzed according to per-protocol and intent-to-treat (ITT) results. The minimally clinically important difference (MCID) and number needed to treat (NNT) were also calculated.Results. Thirty-three studies representing 3,180 men and women (1,857 exercise, 1,323 control) with rheumatoid arthritis, osteoarthritis, and fibromyalgia were included. Statistically significant and clinically important improvements were observed for pain (per-protocol g = -0.37 [95% confidence interval (95% CI) -0.53, -0.21], MCID -18%; ITT g = -0.20 [95% CI -0.33, -0.07], MCID -9%, NNT 9) and physical function (per-protocol g = 0.37 [95% CI 0.21, 0.52], MCID 15%; ITT g = 0.34 [95% CI 0.25, 0.43], MCID 10%, NNT 5).Conclusion. Community-deliverable exercise improves pain and physical function in adults with the types of AORD included in the analysis. Dose-response as well as studies in those with other types of AORD is needed.