膝骨关节炎非手术治疗患者运动干预的最佳证据总结

目的 总结膝骨关节炎非手术治疗患者运动干预的最佳证据，为临床膝骨关节炎非手术治疗患者的运动康复提供参考。方法 确定循证问题，依照“6S”证据模型，计算机检索JBI循证卫生保健中心数据库、BMJ、英国国家卫生与临床优化研究所指南网等国内外数据库中关于膝骨关节炎非手术治疗患者运动干预的所有证据，包括指南、系统评价、证据总结、专家共识、临床决策、随机对照试验，检索时限为2018年2月10日至2023年2月10日。由2名研究者独立完成文献质量评价、证据提取和总结。结果 共纳入12篇文献，其中指南6篇，系统评价2篇，专家共识2篇以及随机对照试验2篇。从运动原则、运动评估、运动类型、运动强度、运动频率和时间、运动监测6个方面共汇总27条最佳证据。结论 膝骨关节炎患者运动方案的制定应遵循运动频率、强度、时间和类型原则，医护人员在临床应结合患者自身状况意愿、证据应用情境等因素选择证据，个体化制定患者的运动干预计划。

Summary of the best evidence regarding exercise intervention for patients receiving non-surgical treatment for knee osteoarthritis

Objective To summarize the best evidence regarding exercise intervention for patients receiving non-surgical treatment for knee osteoarthritis，and to provide a basis for clinical exercise rehabilitation of these patients. Methods The clinical questions in need of evidence-based problem-solving approach were determined. According to the "6S" evidence model, all evidence on exercise intervention for patients receiving non-surgical treatment for osteoarthritis of the knee in domestic and international databases/websites，such as JBI′s EBP database，the BMJ，and National Institute for Health and Care Excellence (NICE)，was searched by computer. The types of literature included guidelines，systematic reviews，evidence summaries，expert consensus reports，and clinical decisions，randomized controlled trials，and the search time frame was limited from 10 February 2018 to 10 February 2023. Literature quality assessment，evidence extraction，and summarization were conducted independently by 2 researchers. Results A total of 12 publications (including 6 guidelines, 2 systematic reviews, 2 expert consensus reports and 2 randomized controlled trials) were retrieved. A total of 27 pieces of best evidences were summarized into 6 aspects，including exercise principles，exercise assessment, exercise types, exercise intensity, exercise frequency and duration, and exercise monitoring. Conclusion The development of exercise programs for patients with osteoarthritis of the knee should follow the principles of frequency, intensity, duration and type of exercise, and healthcare professionals should take into account such factors as patient′s own wishes, the scenarios of evidence application before developing individualized exercise intervention plan for these patients.