Proprioception is significantly impaired in knee osteoarthritis(KOA),contributing to reduced functionality.Strength training(ST)is essential in KOA by improving muscle strength,although it may also be effective in imp...Proprioception is significantly impaired in knee osteoarthritis(KOA),contributing to reduced functionality.Strength training(ST)is essential in KOA by improving muscle strength,although it may also be effective in improving proprioception.The purpose was to determine the effect of ST on knee proprioception in KOA patients.Pubmed,CINAHL,Scopus,WOS,and PEDro were searched for randomized controlled trials(RCTs)(inception to March 2023).Comparisons for ST were physical exercise different from ST,non-exercise-based interventions,and no intervention.Methodological quality was assessed using the PEDro scale,and risk of bias(RoB)using the Cochrane tool.Meta-analyses were performed by comparison groups using the standardized mean difference(SMD)(Hedge's g)with random effects models,also considering subgroups by proprioception tests.Finally,six RCTs were included.The mean PEDro score was 6.3,and the highest proportion of biases corresponds to per-formance,selection,and detection.The meta-analysis indicated that only when compared with non-intervention,ST significantly improved knee proprioception for the joint position sense(JPS)(activeþpassive),JPS(passive),and threshold to detect passive motion(TTDPM)subgroups(g=-1.33[-2.33,-0.32],g=-2.29[-2.82,-1.75]and g=-2.40[-4.23,-0.58],respectively).However,in the knee JPS(active)subgroup,ST was not significant(g=-0.72[-1.84,0.40]).In conclusion,ST improves knee proprioception compared to non-intervention.However,due to the paucity of studies and diversity of interventions,more evidence is needed to support the effectiveness of ST.Future RCTs may address the limitations of this review to advance knowledge about pro-prioceptive responses to ST and contribute to clinical practice.展开更多
Chronic neck pain(CNP)is a worldwide health problem with several risk factors.One of the most widely used treatments for managing this condition is therapeutic exercise,which could generate a response called exercisei...Chronic neck pain(CNP)is a worldwide health problem with several risk factors.One of the most widely used treatments for managing this condition is therapeutic exercise,which could generate a response called exerciseinduced hypoalgesia(EIH).There is no consensus on the best exercise modality to induce hypoalgesia.Therefore,this review aims to analyze and synthesize the state-of-the-art about the hypoalgesic effect of exercise in subjects with CNP.We included articles on EIH and CNP in patients older than 18 years,with pain for more than three months,where the EIH response was measured.Articles that studied CNP associated with comorbidities or measured the response to treatments other than exercise were excluded.The studies reviewed reported variable results.Exercise in healthy subjects has been shown to reduce indicators of pain sensitivity;however,in people with chronic pain,the response is variable.Some investigations reported adverse effects with increased pain intensity and decreased pain sensitivity,others found no clinical response,and some even reported EIH with decreased pain and increased sensitivity.EIH is an identifiable,stimulable,and helpful therapeutic response in people with pain.More research is still needed on subjects with CNP to clarify the protocols and therapeutic variables that facilitate the EIH phenomenon.In addition,it is necessary to deepen the knowledge of the intrinsic and extrinsic factors that influence EIH in people with CNP.展开更多
文摘Proprioception is significantly impaired in knee osteoarthritis(KOA),contributing to reduced functionality.Strength training(ST)is essential in KOA by improving muscle strength,although it may also be effective in improving proprioception.The purpose was to determine the effect of ST on knee proprioception in KOA patients.Pubmed,CINAHL,Scopus,WOS,and PEDro were searched for randomized controlled trials(RCTs)(inception to March 2023).Comparisons for ST were physical exercise different from ST,non-exercise-based interventions,and no intervention.Methodological quality was assessed using the PEDro scale,and risk of bias(RoB)using the Cochrane tool.Meta-analyses were performed by comparison groups using the standardized mean difference(SMD)(Hedge's g)with random effects models,also considering subgroups by proprioception tests.Finally,six RCTs were included.The mean PEDro score was 6.3,and the highest proportion of biases corresponds to per-formance,selection,and detection.The meta-analysis indicated that only when compared with non-intervention,ST significantly improved knee proprioception for the joint position sense(JPS)(activeþpassive),JPS(passive),and threshold to detect passive motion(TTDPM)subgroups(g=-1.33[-2.33,-0.32],g=-2.29[-2.82,-1.75]and g=-2.40[-4.23,-0.58],respectively).However,in the knee JPS(active)subgroup,ST was not significant(g=-0.72[-1.84,0.40]).In conclusion,ST improves knee proprioception compared to non-intervention.However,due to the paucity of studies and diversity of interventions,more evidence is needed to support the effectiveness of ST.Future RCTs may address the limitations of this review to advance knowledge about pro-prioceptive responses to ST and contribute to clinical practice.
文摘Chronic neck pain(CNP)is a worldwide health problem with several risk factors.One of the most widely used treatments for managing this condition is therapeutic exercise,which could generate a response called exerciseinduced hypoalgesia(EIH).There is no consensus on the best exercise modality to induce hypoalgesia.Therefore,this review aims to analyze and synthesize the state-of-the-art about the hypoalgesic effect of exercise in subjects with CNP.We included articles on EIH and CNP in patients older than 18 years,with pain for more than three months,where the EIH response was measured.Articles that studied CNP associated with comorbidities or measured the response to treatments other than exercise were excluded.The studies reviewed reported variable results.Exercise in healthy subjects has been shown to reduce indicators of pain sensitivity;however,in people with chronic pain,the response is variable.Some investigations reported adverse effects with increased pain intensity and decreased pain sensitivity,others found no clinical response,and some even reported EIH with decreased pain and increased sensitivity.EIH is an identifiable,stimulable,and helpful therapeutic response in people with pain.More research is still needed on subjects with CNP to clarify the protocols and therapeutic variables that facilitate the EIH phenomenon.In addition,it is necessary to deepen the knowledge of the intrinsic and extrinsic factors that influence EIH in people with CNP.
