Reumatizam, Vol. 62 No. suppl. 1, 2015.
Pregledni rad
OSTHEOARTHRITIS – EXERCISE AS A DISEASE-MODIFYING DRUG (DMARD)?
Tea Schnurrer-Luke-Vrbanić
Sažetak
The objective of this review is to present evidence-based recommendations
and guidelines for exercise as a non-pharmacological
management of osteoarthritis (OA), as well as
regarding the effects of exercise on pain and function. The
review also aims at providing the answer to the question
whether exercise might be useful as a disease-modifying
anti-rheumatic drug.
A literature survey shows that the majority of recommendations
were published for knee, hip, and hand OA, because
the estimated prevalence of OA in elderly people is the
highest in these three joint levels.
The general recommendations for the selection of exercises
in older people and chronically ill persons with knee OA
are aerobic moderate-intensity training and progressive
strength training involving the major muscle groups, with
high-quality research evidence corroborating pain reduction
and improved physical function. A combination of diet
and exercise results in less knee pain and better function
than each of the methods implemented separately.
In view of the fact of multiple studies demonstrating that
serum cytokine levels, which are markers of chronic lowgrade
inflammation, are elevated in OA, it has been proven
that regular exercise has an anti-inflammatory effect on mediators of inflammation. Furthermore, since obesity
is known to be a part of metabolic syndrome and a risk
factor in the development of OA, it has been established
recently that exercise may be considered as the most effective
non-pharmacological tool for the treatment of metabolic
syndrome and obesity. By introducing a program
combining diet and exercise, better anti-inflammatory,
analgesic, and functional effects have been achieved than
by diet or exercise individually.
Conclusion. Exercise is the cornerstone non-pharmacological
method in the management of OA. Both aerobic
and strengthening exercises have been found to be effective
in terms of decreasing pain and improving function.
Considering the fact that OA is a chronic low-grade inflammatory
disease, one of the recently investigated exercise
effects is a decrease of serum pro-inflammatory cytokine
levels and an increase of anti-inflammatory cytokines.
Unfortunately, due to the absence of a larger number of
studies on the anti-inflammatory effects of exercise, the
existing results, although promising, may still be inconsistent
because of the various limitations in the research
methodologies.
Ključne riječi
cytokines; exercise; function; osteoarthritis; pain
Hrčak ID:
182729
URI
Datum izdavanja:
10.10.2015.
Posjeta: 3.242 *