Effectiveness of Traditional Chinese Exercise for Symptoms of Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Effectiveness of Traditional Chinese Exercise for Symptoms of Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
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DOI：
10.3390/ijerph17217873
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发表时间：
2020-10-27
影响因子：
--
通讯作者：
Xiao H
中科院分区：
文献类型：
--
作者：
Li R;Chen H;Feng J;Xiao Y;Zhang H;Lam CW;Xiao H
背景资料：越来越多的证据表明，传统的中国运动（TCE）对膝关节骨关节炎（KOA）症状的改善具有潜在的益处。然而，其中大部分来自横断面研究或病例报告; TCE治疗的有效性尚未通过随机对照试验（RCT）进行充分评估。为了评价TCE治疗KOA的综合临床有效性，我们对现有的KOA RCT进行了系统回顾和荟萃分析。研究方法：在四个电子数据库中进行了系统检索：PubMed、Web of Science、科克伦图书馆和EMBASE，从其成立之日起至2020年2月。纳入了所有合格的RCT，与对照组相比，TCE用于治疗KOA。两名评价者独立提取数据，并根据随机对照试验的科克伦偏倚风险工具评价偏倚风险。通过西安大略和麦克马斯特大学关节炎指数（WOMAC）和膝关节损伤和骨关节炎结局评分（KOOS）评估的KOA症状被视为本研究的主要结局。每个结果指标通过标准化平均差（SMD）和95%置信区间（CI）合并。采用随机或固定效应模型对收集的数据进行荟萃分析，以基于不同的统计异质性计算汇总SMD和95% CI。此外，采用亚组分析研究异质性，并对荟萃分析结果进行敏感性分析。使用Egger检验和漏斗图检查RCT中的潜在偏倚。结果：共纳入14项随机对照试验，涉及815例KOA患者。与对照组比较，TCE的综合数据显示WOMAC/KOOS疼痛评分显著改善（SMD = −0.61; 95% CI：−0.86至−0.37; p < 0.001），僵硬评分（SMD = −0.75; 95%CI：−1.09至−0.41; p < 0.001）和身体功能评分（SMD = −0.67; 95%CI：−0.82至−0.53; p < 0.001）。结论：我们的荟萃分析表明，TCE可以有效地缓解疼痛，缓解僵硬和改善KOA患者的身体功能。然而;鉴于本次荟萃分析纳入的随机对照试验存在方法学局限性，需要更多高质量的大样本、长期干预的随机对照试验来进一步证实TCE治疗KOA的有效性和潜在机制。
Background: Growing evidences have advocated the potential benefits of traditional Chinese exercise (TCE) on symptomatic improvement of knee osteoarthritis (KOA). However, most of them have been derived from cross-sectional studies or case reports; the effectiveness of TCE therapies has not been fully assessed with a randomized control trial (RCT). In order to evaluate the combined clinical effectiveness of TCE for KOA, we conducted a systematic review and meta-analysis on the existing RCTs on KOA. Methods: A systematic search was performed in four electronic databases: PubMed, Web of Science, Cochrane Library, and EMBASE from the time of their inception to February 2020. All eligible RCTs were included in which TCE was utilized for treating KOA as compared to a control group. Two reviewers independently extracted the data and evaluated the risk of bias following the Cochrane Risk of Bias Tool for RCT. The symptoms of KOA evaluated by the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) were regarded as the primary outcomes in this study. Each outcome measure was pooled by a standardized mean difference (SMD) with 95% confidence intervals (CI). A meta-analysis was applied with a random or fixed effect model for the collected data to calculate the summary SMD with 95% CI based on different statistical heterogeneity. In addition, subgroup analyses were used to investigate heterogeneity and sensitivity analysis was carried out for the results of the meta-analysis. Egger’s test and the funnel plots were used to examine the potential bias in the RCTs. Results: A total of 14 RCTs involving 815 patients with KOA were included. Compared with a control group; the synthesized data of TCE showed a significant improvement in WOMAC/KOOS pain score (SMD = −0.61; 95% CI: −0.86 to −0.37; p < 0.001), stiffness score (SMD = −0.75; 95% CI: −1.09 to −0.41; p < 0.001), and physical function score (SMD = −0.67; 95% CI: −0.82 to −0.53; p < 0.001). Conclusions: Our meta-analysis suggested that TCE may be effective in alleviating pain; relieving stiffness and improving the physical function for patients with KOA. Yet; given the methodological limitations of included RCTs in this meta-analysis; more high-quality RCTs with large sample size and long-term intervention are required to further confirm the effectiveness and underlying mechanisms of TCE for treating KOA.
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影响因子：
2.2
作者：
Jung, Sun-Young;Jang, Eun Jin;Sung, Yoon-Kyoung
通讯作者：
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影响因子：
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作者：
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影响因子：
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作者：
KOH, TC
通讯作者：
KOH, TC