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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2020; 55(05): 509-517
DOI: 10.1055/s-0039-1696681
Artigo de Revisão
Joelho

Os efeitos do exercício físico sobre o manejo da dor em pacientes com osteoartrose de joelho: Uma revisão sistemática com meta-análise[*]

Article in several languages: português | English
Thiago Casali Rocha
1   Faculdade de Ciências Médicas e da Saúde de Juiz de Fora, Hospital e Maternidade Therezinha de Jesus, Juiz de Fora, MG, Brazil
,
Plínio dos Santos Ramos
1   Faculdade de Ciências Médicas e da Saúde de Juiz de Fora, Hospital e Maternidade Therezinha de Jesus, Juiz de Fora, MG, Brazil
,
Alessandra Germano Dias
2   Latu Sensu Graduation Program in Traumatic and Orthopedics Physical Therapy, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora, Juiz de Fora, MG, Brazil
,
Elaine Angélica Martins
2   Latu Sensu Graduation Program in Traumatic and Orthopedics Physical Therapy, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora, Juiz de Fora, MG, Brazil
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Resumo

Objetivo O presente estudo verificou por meio de uma revisão sistemática com metanálise os efeitos de um programa de reabilitação, através de um programa de treinamento físico, para o tratamento da dor e força muscular na osteoartrose (OA) de joelho.

Métodos Foram analisados os estudos publicados entre 2008 e 2018, tendo como referência a base de dados Medline (National Library of Medicine), da qual foram selecionados 7 ensaios clínicos controlados randomizados que pontuaram acima de 8 na escala Physiotherapy Evidence Database (PeDro, na sigla em inglês), sobre programas de exercícios na melhora da dor e força muscular em paciente com OA de joelho. Foi usada a sistematização Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA, na sigla em inglês) para a elaboração desta revisão e a realização de uma metanálise com o objetivo de evidenciar matematicamente os resultados do exercício físico sobre a dor.

Resultados Os estudos incluídos na análise continham um total de 934 participantes com idade entre 40 a 73 anos, sendo que 34,90% desses eram do sexo masculino. A maioria dos conjuntos de exercícios oferecidos no tratamento da OA tiveram resultado significativamente positivo em ambos os quesitos, mas principalmente para o alívio da dor (estatisticamente significativo p < 0, 003).

Conclusão Inferimos que houve uma melhora da dor em todos os artigos que realizaram fortalecimento muscular, porém ainda há um óbice sobre os protocolos utilizados.

Palavras-chave

dor - força muscular - osteoartrite de joelho - técnicas de exercício e de movimento

* Trabalho desenvolvido na Faculdade de Ciências Médicas e da Saúde de Juiz de Fora, Hospital e Maternidade Therezinha de Jesus, Juiz de Fora, MG, Brasil.




Publication History

Received: 04 November 2018

Accepted: 12 March 2019

Article published online:
23 September 2019

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revnter Publicações Ltda
Rio de Janeiro, Brazil

 

  • Referências

  • 1 van der Pas S, Castell MV, Cooper C. et al. European project on osteoarthritis: design of a six-cohort study on the personal and societal burden of osteoarthritis in an older European population. BMC Musculoskelet Disord 2013; 14: 138
    CrossrefPubMedGoogle Scholar
  • 2 Felson DT. The epidemiology of knee osteoarthritis: results from the Framingham Osteoarthritis Study. Semin Arthritis Rheum 1990; 20 (03) (Suppl. 01) 42-50
    CrossrefPubMedGoogle Scholar
  • 3 Lane NE, Brandt K, Hawker G. et al. OARSI-FDA initiative: defining the disease state of osteoarthritis. Osteoarthritis Cartilage 2011; 19 (05) 478-482
    CrossrefPubMedGoogle Scholar
  • 4 Conn VS, Hafdahl AR, Minor MA, Nielsen PJ. Physical activity interventions among adults with arthritis: meta-analysis of outcomes. Semin Arthritis Rheum 2008; 37 (05) 307-316
    CrossrefPubMedGoogle Scholar
  • 5 Kerkhof HJ, Bierma-Zeinstra SM, Arden NK. et al. Prediction model for knee osteoarthritis incidence, including clinical, genetic and biochemical risk factors. Ann Rheum Dis 2014; 73 (12) 2116-2121
    CrossrefPubMedGoogle Scholar
  • 6 Sharma L, Song J, Dunlop D. et al. Varus and valgus alignment and incident and progressive knee osteoarthritis. Ann Rheum Dis 2010; 69 (11) 1940-1945
    CrossrefPubMedGoogle Scholar
  • 7 Otterness IG, Eckstein F. Women have thinner cartilage and smaller joint surfaces than men after adjustment for body height and weight. Osteoarthritis Cartilage 2007; 15 (06) 666-672
    CrossrefPubMedGoogle Scholar
  • 8 Nguyen C, Lefèvre-Colau MM, Poiraudeau S, Rannou F. Rehabilitation (exercise and strength training) and osteoarthritis: A critical narrative review. Ann Phys Rehabil Med 2016; 59 (03) 190-195
    CrossrefPubMedGoogle Scholar
  • 9 McAlindon TE, Bannuru RR, Sullivan MC. et al. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis Cartilage 2014; 22 (03) 363-388
    CrossrefPubMedGoogle Scholar
  • 10 Lange AK, Vanwanseele B, Fiatarone Singh MA. Strength training for treatment of osteoarthritis of the knee: a systematic review. Arthritis Rheum 2008; 59 (10) 1488-1494
    CrossrefPubMedGoogle Scholar
  • 11 Tanaka R, Ozawa J, Kito N, Moriyama H. Efficacy of strengthening or aerobic exercise on pain relief in people with knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Clin Rehabil 2013; 27 (12) 1059-1071
    CrossrefPubMedGoogle Scholar
  • 12 Levinger P, Dunn J, Bifera N, Butson M, Elias G, Hill KD. High-speed resistance training and balance training for people with knee osteoarthritis to reduce falls risk: study protocol for a pilot randomized controlled trial. Trials 2017; 18 (01) 384
    CrossrefPubMedGoogle Scholar
  • 13 Mat S, Tan MP, Kamaruzzaman SB, Ng CT. Physical therapies for improving balance and reducing falls risk in osteoarthritis of the knee: a systematic review. Age Ageing 2015; 44 (01) 16-24
    CrossrefPubMedGoogle Scholar
  • 14 Hatfield GL, Morrison A, Wenman M, Hammond CA, Hunt MA. Clinical Tests of Standing Balance in the Knee Osteoarthritis Population: Systematic Review and Meta-analysis. Phys Ther 2016; 96 (03) 324-337
    CrossrefPubMedGoogle Scholar
  • 15 Li Y, Su Y, Chen S. et al. The effects of resistance exercise in patients with knee osteoarthritis: a systematic review and meta-analysis. Clin Rehabil 2016; 30 (10) 947-959
    CrossrefPubMedGoogle Scholar
  • 16 Iwamoto J, Sato Y, Takeda T, Matsumoto H. Effectiveness of exercise for osteoarthritis of the knee: A review of the literature. World J Orthop 2011; 2 (05) 37-42
    CrossrefPubMedGoogle Scholar
  • 17 Jan MH, Lin CH, Lin YF, Lin JJ, Lin DH. Effects of weight-bearing versus nonweight-bearing exercise on function, walking speed, and position sense in participants with knee osteoarthritis: a randomized controlled trial. Arch Phys Med Rehabil 2009; 90 (06) 897-904
    CrossrefPubMedGoogle Scholar
  • 18 Bartholdy C, Juhl C, Christensen R, Lund H, Zhang W, Henriksen M. The role of muscle strengthening in exercise therapy for knee osteoarthritis: A systematic review and meta-regression analysis of randomized trials. Semin Arthritis Rheum 2017; 47 (01) 9-21
    CrossrefPubMedGoogle Scholar
  • 19 Jadad AR, Moore RA, Carroll D. et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Control Clin Trials 1996; 17 (01) 1-12
    CrossrefPubMedGoogle Scholar
  • 20 Fitzgerald GK, Piva SR, Gil AB, Wisniewski SR, Oddis CV, Irrgang JJ. Agility and perturbation training techniques in exercise therapy for reducing pain and improving function in people with knee osteoarthritis: a randomized clinical trial. Phys Ther 2011; 91 (04) 452-469
    CrossrefPubMedGoogle Scholar
  • 21 Saccomanno MF, Donati F, Careri S, Bartoli M, Severini G, Milano G. Efficacy of intra-articular hyaluronic acid injections and exercise-based rehabilitation programme, administered as isolated or integrated therapeutic regimens for the treatment of knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 2016; 24 (05) 1686-1694
    CrossrefPubMedGoogle Scholar
  • 22 Palmer S, Domaille M, Cramp F. et al. Transcutaneous electrical nerve stimulation as an adjunct to education and exercise for knee osteoarthritis: a randomized controlled trial. Arthritis Care Res (Hoboken) 2014; 66 (03) 387-394
    CrossrefPubMedGoogle Scholar
  • 23 Holsgaard-Larsen A, Clausen B, Søndergaard J, Christensen R, Andriacchi TP, Roos EM. The effect of instruction in analgesic use compared with neuromuscular exercise on knee-joint load in patients with knee osteoarthritis: a randomized, single-blind, controlled trial. Osteoarthritis Cartilage 2017; 25 (04) 470-480
    CrossrefPubMedGoogle Scholar
  • 24 Jorge RT, Souza MC, Chiari A. et al. Progressive resistance exercise in women with osteoarthritis of the knee: a randomized controlled trial. Clin Rehabil 2015; 29 (03) 234-243
    CrossrefPubMedGoogle Scholar
  • 25 Bennell KL, Hunt MA, Wrigley TV. et al. Hip strengthening reduces symptoms but not knee load in people with medial knee osteoarthritis and varus malalignment: a randomised controlled trial. Osteoarthritis Cartilage 2010; 18 (05) 621-628
    CrossrefPubMedGoogle Scholar
  • 26 Creamer P, Lethbridge-Cejku M, Hochberg MC. Factors associated with functional impairment in symptomatic knee osteoarthritis. Rheumatology (Oxford) 2000; 39 (05) 490-496
    CrossrefPubMedGoogle Scholar
  • 27 O'Reilly SC, Jones A, Muir KR, Doherty M. Quadriceps weakness in knee osteoarthritis: the effect on pain and disability. Ann Rheum Dis 1998; 57 (10) 588-594
    CrossrefPubMedGoogle Scholar
  • 28 Avelar Di Sabatino Santos ML, Fabiano Gomes W, Zille de Queiroz B, Brito Rosa NMd, Sirineu Pereira D, Domingues Dias JM. et al. Desempenho muscular, dor, rigidez e funcionalidade de idosas com osteoartrite de joelho. Acta Ortop Bras 2011;19(04):
    Google Scholar
  • 29 Schipplein OD, Andriacchi TP. Interaction between active and passive knee stabilizers during level walking. J Orthop Res 1991; 9 (01) 113-119
    CrossrefPubMedGoogle Scholar
  • 30 Bolognese JA, Schnitzer TJ, Ehrich EW. Response relationship of VAS and Likert scales in osteoarthritis efficacy measurement. Osteoarthritis Cartilage 2003; 11 (07) 499-507
    CrossrefPubMedGoogle Scholar
  • 31 Alnahdi AH, Zeni JA, Snyder-Mackler L. Muscle impairments in patients with knee osteoarthritis. Sports Health 2012; 4 (04) 284-292
    CrossrefPubMedGoogle Scholar
  • 32 Segal NA, Glass NA, Felson DT. et al. Effect of quadriceps strength and proprioception on risk for knee osteoarthritis. Med Sci Sports Exerc 2010; 42 (11) 2081-2088
    CrossrefPubMedGoogle Scholar
  • 33 Lim BW, Hinman RS, Wrigley TV, Sharma L, Bennell KL. Does knee malalignment mediate the effects of quadriceps strengthening on knee adduction moment, pain, and function in medial knee osteoarthritis? A randomized controlled trial. Arthritis Rheum 2008; 59 (07) 943-951
    CrossrefPubMedGoogle Scholar
  • 34 Foroughi N, Smith RM, Lange AK, Singh MA, Vanwanseele B. Progressive resistance training and dynamic alignment in osteoarthritis: A single-blind randomised controlled trial. Clin Biomech (Bristol, Avon) 2011; 26 (01) 71-77
    CrossrefPubMedGoogle Scholar
  • 35 Weng MC, Lee CL, Chen CH. et al. Effects of different stretching techniques on the outcomes of isokinetic exercise in patients with knee osteoarthritis. Kaohsiung J Med Sci 2009; 25 (06) 306-315
    CrossrefPubMedGoogle Scholar
  • 36 Ferreira de Meneses SR, Hunter DJ, Young Docko E, Pasqual Marques A. Effect of low-level laser therapy (904 nm) and static stretching in patients with knee osteoarthritis: a protocol of randomised controlled trial. BMC Musculoskelet Disord 2015; 16: 252
    CrossrefPubMedGoogle Scholar
  • 37 Diracoglu D, Aydin R, Baskent A, Celik A. Effects of kinesthesia and balance exercises in knee osteoarthritis. J Clin Rheumatol 2005; 11 (06) 303-310
    CrossrefPubMedGoogle Scholar
  • 38 Marx FC, Oliveira LM, Bellini CG, Ribeiro MCC. Tradução e validação cultural do questionário algofuncional de Lequesne para osteoartrite de joelhos e quadris para a língua portuguesa. Rev Bras Reumatol 2006; 46 (04) 253-260
    Google Scholar