Institut Régional de Formation aux Métiers de Rééducation et de Réadaptation des Pays de la Loire.
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Auteur Siew-Li Goh
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Efficacy and potential determinants of exercise therapy in knee and hip osteoarthritis: A systematic review and meta-analysis / Siew-Li Goh in Annals of physical and rehabilitation medicine, Vol. 62 n° 5 (September 2019)
[article] Efficacy and potential determinants of exercise therapy in knee and hip osteoarthritis: A systematic review and meta-analysis [texte imprimé] / Siew-Li Goh, Auteur ; Monica S.M. Persson, Auteur ; Joanne Stocks, Auteur . - 2019 . - p. 356-365.
Langues : Anglais (eng) Français (fre)
in Annals of physical and rehabilitation medicine > Vol. 62 n° 5 (September 2019) . - p. 356-365
Catégories : PATHOLOGIE
INFORMATION & COMMUNICATION
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Genou , Hanche
Tags : Knee osteoarthritis Exercise Meta-analysis Determinants Physical therapy Pain Function Quality of Life Résumé : Background: Exercise is an effective treatment for osteoarthritis. However, the effect may vary from one patient (or study) to another.
Objective: To evaluate the efficacy of exercise and its potential determinants for pain, function, performance, and quality of life (QoL) in knee and hip osteoarthritis (OA).
Methods: We searched 9 electronic databases (AMED, CENTRAL, CINAHL, EMBASE, MEDLINE Ovid, PEDro, PubMed, SPORTDiscus and Google Scholar) for reports of randomised controlled trials (RCTs) comparing exercise-only interventions with usual care. The search was performed from inception up to December 2017 with no language restriction. The effect size (ES), with its 95% confidence interval (CI), was calculated on the basis of between-group standardised mean differences. The primary endpoint was at or nearest to 8 weeks. Other outcome time points were grouped into intervals, from Results: Data from 77 RCTs (6472 participants) confirmed statistically significant exercise benefits for pain (ES 0.56, 95% CI 0.440.68), function (0.50, 0.380.63), performance (0.46, 0.350.57), and QoL (0.21, 0.110.31) at or nearest to 8 weeks. Across all outcomes, the effects appeared to peak around 2 months and then gradually decreased and became no better than usual care after 9 months. Better pain relief was reported by trials investigating participants who were younger (mean age Conclusions: Exercise significantly reduces pain and improves function, performance and QoL in people with knee and hip OA as compared with usual care at 8 weeks. The effects are maximal around 2 months and thereafter slowly diminish, being no better than usual care at 9 to 18 months. Participants with younger age, knee OA and not awaiting joint replacement may benefit more from exercise therapy. These potential determinants, identified by study-level analyses, may have implied ecological bias and need to be confirmed with individual patient data.
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