Exercise therapy for bone and muscle health: an overview of systematic reviews.
Exercise therapy for bone and muscle health: an overview of systematic reviews.
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DOI：
10.1186/1741-7015-10-167
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发表时间：
2012-12-19
期刊：
影响因子：
9.3
通讯作者：
Smedslund G
中科院分区：
文献类型：
--
作者：
Hagen KB;Dagfinrud H;Moe RH;Østerås N;Kjeken I;Grotle M;Smedslund G
肌肉骨骼疾病（MSCs）在当今社会广泛流行，导致高昂的医疗费用和对患者健康和生活质量的重大负面影响。本综述的主要目的是综合系统综述中关于运动疗法（ET）对MSCs患者疼痛和身体功能影响的证据。此外，研究人员还探讨了ET对疾病发病机制的影响，以及运动项目的特定组成部分是否与治疗效果的大小有关。我们纳入了四种常见疾病：纤维肌痛（FM）、腰痛（LBP）、颈痛（NP）和肩痛（SP），以及四种特定的肌肉骨骼疾病：骨关节炎（OA）、类风湿性关节炎（RA）、强直性脊柱炎（AS）和骨质疏松症（OP）。我们首先纳入了最近更新于2007年1月或之后的Cochrane综述，然后搜索在此日期之后发表的非Cochrane综述。疼痛和身体功能被选为主要结局。我们确定了9篇综述，包括224项试验和24,059名患者。此外，还对运动对发病机制的影响进行了综述。总的来说，我们发现了确凿的证据支持间充质干细胞管理中的ET，但在纳入的诊断组之间，研究证据的水平存在实质性差异。膝关节OA、LBP、FM和SP的标准化平均差异在0.30至0.65之间，明显有利于疼痛和功能的锻炼。对于NP、髋关节OA、RA和AS，效应估计通常较小且并不总是显著。很少或没有证据表明ET可以影响疾病的发病机制。唯一的例外是骨质疏松症，有证据表明ET增加绝经后妇女的骨密度，但对临床相关结果（骨折）没有显著影响。对于腰痛和膝关节炎，有证据表明，治疗效果随着锻炼次数的增加而增加。有经验证据表明，ET对大多数间充质干细胞具有有益的临床效果。除了骨质疏松症外，在了解ET影响疾病机制的方式方面似乎存在差距。
Musculoskeletal conditions (MSCs) are widely prevalent in present-day society, with resultant high healthcare costs and substantial negative effects on patient health and quality of life. The main aim of this overview was to synthesize evidence from systematic reviews on the effects of exercise therapy (ET) on pain and physical function for patients with MSCs. In addition, the evidence for the effect of ET on disease pathogenesis, and whether particular components of exercise programs are associated with the size of the treatment effects, was also explored. We included four common conditions: fibromyalgia (FM), low back pain (LBP), neck pain (NP), and shoulder pain (SP), and four specific musculoskeletal diseases: osteoarthritis (OA), rheumatoid arthritis (RA), ankylosing spondylitis (AS), and osteoporosis (OP). We first included Cochrane reviews with the most recent update being January 2007 or later, and then searched for non-Cochrane reviews published after this date. Pain and physical functioning were selected as primary outcomes. We identified 9 reviews, comprising a total of 224 trials and 24,059 patients. In addition, one review addressing the effect of exercise on pathogenesis was included. Overall, we found solid evidence supporting ET in the management of MSCs, but there were substantial differences in the level of research evidence between the included diagnostic groups. The standardized mean differences for knee OA, LBP, FM, and SP varied between 0.30 and 0.65 and were significantly in favor of exercise for both pain and function. For NP, hip OA, RA, and AS, the effect estimates were generally smaller and not always significant. There was little or no evidence that ET can influence disease pathogenesis. The only exception was for osteoporosis, where there was evidence that ET increases bone mineral density in postmenopausal women, but no significant effects were found for clinically relevant outcomes (fractures). For LBP and knee OA, there was evidence suggesting that the treatment effect increases with the number of exercise sessions. There is empirical evidence that ET has beneficial clinical effects for most MSCs. Except for osteoporosis, there seems to be a gap in the understanding of the ways in which ET influences disease mechanisms.
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影响因子：
120.7
作者：
Jadad, AR;Cook, DJ;Moher, D
通讯作者：
Moher, D
DOI：
10.1016/j.berh.2007.11.002
发表时间：
2008-06-01
影响因子：
5.2
作者：
Dziedzic, Krysia;Jordan, Joanne L.;Foster, Nadine E.
通讯作者：
Foster, Nadine E.
影响因子：
3
作者：
Guzman, Jaime;Hurwitz, Eric L.;Cassidy, J. David
通讯作者：
Cassidy, J. David
影响因子：
168.9
作者：
Hill, Jonathan C.;Whitehurst, David G. T.;Hay, Elaine M.
通讯作者：
Hay, Elaine M.
影响因子：
4.1
作者：
Garber, Carol Ewing;Blissmer, Bryan;Swain, David P.
通讯作者：
Swain, David P.