Immediate and Delayed Effects of Joint Loading Activities on Knee and Hip Cartilage: A Systematic Review and Meta-analysis.
Immediate and Delayed Effects of Joint Loading Activities on Knee and Hip Cartilage: A Systematic Review and Meta-analysis.
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DOI：
10.1186/s40798-023-00602-7
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发表时间：
2023-07-14
影响因子：
4.6
通讯作者：
Culvenor, Adam G. G.
中科院分区：
文献类型：
--
作者：
Coburn, Sally L. L.;Crossley, Kay M. M.;Kemp, Joanne L. L.;Warden, Stuart J. J.;West, Tom J. J.;Bruder, Andrea M. M.;Mentiplay, Benjamin F. F.;Culvenor, Adam G. G.
活动相关的关节负荷对软骨的影响尚不清楚。异常负荷被认为是骨关节炎(OA)的机械驱动因素，但适量的体力活动和康复运动可以对关节软骨产生积极影响。我们的目的是调查关节负荷活动对健康成年人膝关节和髋关节软骨的即时影响，通过磁共振成像进行评估。我们还研究了活动对健康软骨的延迟效应，以及活动对患有或有骨性关节炎风险的成年人软骨的影响。我们探讨了性别、年龄和加载时间与软骨变化的关系。一项对六个数据库的系统回顾确定了在应用关节负荷干预/活动之前和之后48小时内使用MRI评估成人髋关节和膝关节软骨变化的研究。研究包括软骨健康的成年人或患有或有骨性关节炎风险的人。联合负荷活动包括步行、跳跃、骑自行车、负重屈膝和模拟站立在扫描仪内。使用纽卡斯尔-渥太华量表评估偏倚的风险。随机效应荟萃分析估计了特定间隔软骨厚度或体积和成分(T2松弛时间)结果的百分比变化。建议等级评定、发展和评价(等级)制度评价证据的确定性。在筛选了5159项检索到的研究后，纳入了653名参与者的40项研究。在调查健康成人的所有负荷活动后，膝关节软骨厚度或体积立即减少；然而，分级评估显示非常低的确定性证据。体重屈膝后，膝关节软骨厚度和体积减少5.0%(95%CI 3.5，6.4，I2 = 89.3%)，胫骨软骨成分(T2松弛时间)减少5.1%(95%CI 3.7，6.5，I2 = 0.0%)。髋关节软骨数据不足以合并。次要结果综合起来表明，膝关节软骨在步行30分钟内恢复，100次屈膝后90分钟内恢复。我们发现，在患有或有骨性关节炎风险的成年人中，模拟站立和行走的效果截然不同。膝关节弯曲重复次数增加10次与膝盖骨厚度或体积减少2%相关。在负重屈膝、模拟站立、行走、跳跃/跳跃和骑车后，膝关节软骨厚度、体积和成分(T2松弛时间)减少(0-5%)的可信度很低，膝关节弯曲的影响可能是剂量依赖的。我们的发现提供了一个健康成年人软骨对负荷反应的框架，这可能对临床医生设计和开出康复方案以及提供运动建议有帮助。网上版载有补充材料，可在10.1186/s40798-023-023-7查阅。
The impact of activity-related joint loading on cartilage is not clear. Abnormal loading is considered to be a mechanical driver of osteoarthritis (OA), yet moderate amounts of physical activity and rehabilitation exercise can have positive effects on articular cartilage. Our aim was to investigate the immediate effects of joint loading activities on knee and hip cartilage in healthy adults, as assessed using magnetic resonance imaging. We also investigated delayed effects of activities on healthy cartilage and the effects of activities on cartilage in adults with, or at risk of, OA. We explored the association of sex, age and loading duration with cartilage changes. A systematic review of six databases identified studies assessing change in adult hip and knee cartilage using MRI within 48 h before and after application of a joint loading intervention/activity. Studies included adults with healthy cartilage or those with, or at risk of, OA. Joint loading activities included walking, hopping, cycling, weightbearing knee bends and simulated standing within the scanner. Risk of bias was assessed using the Newcastle–Ottawa Scale. Random-effects meta-analysis estimated the percentage change in compartment-specific cartilage thickness or volume and composition (T2 relaxation time) outcomes. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system evaluated certainty of evidence. Forty studies of 653 participants were included after screening 5159 retrieved studies. Knee cartilage thickness or volume decreased immediately following all loading activities investigating healthy adults; however, GRADE assessment indicated very low certainty evidence. Patellar cartilage thickness and volume reduced 5.0% (95% CI 3.5, 6.4, I2 = 89.3%) after body weight knee bends, and tibial cartilage composition (T2 relaxation time) decreased 5.1% (95% CI 3.7, 6.5, I2 = 0.0%) after simulated standing within the scanner. Hip cartilage data were insufficient for pooling. Secondary outcomes synthesised narratively suggest knee cartilage recovers within 30 min of walking and 90 min of 100 knee bends. We found contrasting effects of simulated standing and walking in adults with, or at risk of, OA. An increase of 10 knee bend repetitions was associated with 2% greater reduction in patellar thickness or volume. There is very low certainty evidence that minimal knee cartilage thickness and volume and composition (T2 relaxation time) reductions (0–5%) occur after weightbearing knee bends, simulated standing, walking, hopping/jumping and cycling, and the impact of knee bends may be dose dependent. Our findings provide a framework of cartilage responses to loading in healthy adults which may have utility for clinicians when designing and prescribing rehabilitation programs and providing exercise advice. The online version contains supplementary material available at 10.1186/s40798-023-00602-7.
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影响因子：
1.8
作者：
Boeth, Heide;MacMahon, Aoife;Duda, Georg N
通讯作者：
Duda, Georg N
DOI：
10.1007/s004290050291
发表时间：
1999-10-01
期刊：
ANATOMY AND EMBRYOLOGY
影响因子：
--
作者：
Eckstein, F;Tieschky, M;Reiser, M
通讯作者：
Reiser, M
影响因子：
4.6
作者：
Cutcliffe, Hattie C.;DeFrate, Louis E.
通讯作者：
DeFrate, Louis E.
影响因子：
4.9
作者：
Collins AT;Kulvaranon ML;Cutcliffe HC;Utturkar GM;Smith WAR;Spritzer CE;Guilak F;DeFrate LE
通讯作者：
DeFrate LE
影响因子：
3.7
作者：
Chen M;Qiu L;Shen S;Wang F;Zhang J;Zhang C;Liu S
通讯作者：
Liu S