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Polvi- ja lonkkanivelrikko ovat yksi invalidisoivimmista ja eniten kipua aiheuttavista sairauksista. Liikunnalla on useita terveyshyötyjä polvi- ja lonkkanivelrikkoa sairastaville. Liikunnan hyödyistä nivelrikkopotilaille onkin tehty useita tutkimuksia, mutta haittoja ei ole tutkittu systemaattisesti. Tämän systemaattisen kirjallisuuskatsauksen tarkoituksena on selvittää haittojen vakavuutta, tyyppiä ja insidenssiä liikuntainterventiotutkimuksissa. Lisäksi selvitetään miten ja kuinka usein haitat on raportoitu tutkimusartikkeleissa.
Artikkelit haettiin systemaattisesti MEDLINE (via Pubmed), CENTRAL, PEDro, CINAHL ja SPORTDiscus tietokannoista sekä harmaan kirjallisuuden WoS, Clinical trials.gov, ProQuest, OpenGrey sekä ICTRP (WHO) tietokannoista lokakuussa 2015. Katsaukseen hyväksyttiin polvi- ja lonkkanivelrikkopotilaille tehdyt satunnaistetut, kontrolloidut liikuntainterventiotutkimukset sisäänotto- ja poissulkukriteerien mukaan ilman kieli- tai aikarajoituksia.
Systemaattisella haulla löydettiin 5800 artikkelia, joista mukaan valittiin 75 artikkelia eri liikuntainterventiotutkimuksista. Näistä 61,3 % ei raportoinut haitoista, joten lopulliseen tarkasteluun jäi 29 artikkelia. Näissä haittoja raportoitiin tapahtuneen 62,1 %:ssa (n=18). Kaikista haitoista (n=119) 82,4 % oli lieviä tai kohtalaisia (n=98). Vakavia haittoja oli 15,9 % ja kuolemaan johtavia 1,7 %, mutta kaikki haitat eivät johtuneet interventiosta. Ilmenneistä haitoista kipuoireet selittivät 49,6% ja TULE-vaivat 22,6 %. Haittojen raportointi oli heterogeenista ja riittämätöntä niin haittojen määrän, laadun kuin vakavuudenkin osalta ja kaikissa artikkeleissa oli haittojen raportointipuutteita. Artikkeleista 82,8 %:ssa oli raportoitu vain intervention aiheuttamat haitat ja 55,2 %:ssa vain keskeyttämiseen johtaneet haitat. Haittatietojen kerääminen sekä haittojen kesto ja ajoitus oli raportoitu erityisen heikosti.
Polvi -ja lonkkanivelrikkopotilaille tehdyissä liikuntainterventiotutkimuksissa haitat olivat lieviä tai kohtalaisia. Puutteellisen raportoinnin vuoksi tuloksiin tulee kuitenkin suhtautua varauksella. Katsauksen perusteella suositellaan, että liikuntainterventiotutkimuksista kirjoitetuissa tutkimusartikkeleissa intervention aikaisista haitoista käytetään nimitystä ”adverse event” ja haitat raportoidaan tutkimusryhmittäin. Lisäksi haittojen määrä, vakavuus sekä kesto tulee raportoida ja lopuksi määritellä, johtuivatko mahdolliset haitat interventiosta vai eivät. Mikäli intervention aikana ilmenee haittoja, intervention sopeuttaminen, haittojen jatkotoimenpiteet sekä näiden vaikutukset yksilölle tulisi kuvailla tutkimusartikkelissa.
Osteoarthritis (OA) of the knee and hip is a common disease, leading to pain and disability. Exercise has many benefits and it has been widely recommended as treatment of OA. The advantages of exercise for knee and hip OA have been studied but adverse effects (AE’s) for exercise interventions have not been systematically evaluated. The objective of this study is to define the frequency, type and incidence of AE’s in exercise therapy interventions. Also, the quality of reporting AE’s in exercise therapy study articles is being clarified.
A systematic literature search was conducted in October 2015 in databases of MEDLINE (via Pubmed), CENTRAL, PEDro, CINAHL and SPORTDiscus. Also, a grey literature search was conducted in databases of WoS, Clinical trials.gov, ProQuest, OpenGrey and ICTRP (WHO). Studies of randomized controlled trials of exercise interventions for knee and hip OA was accepted according to inclusion and exclusion criteria. No restrictions of language or publication date were made.
5800 articles were found with systematic review, of which 75 articles met the inclusion criteria. However, 61,3 % of studies (n=46) did not report AE’s and were then excluded. 38,7 % of studies (n=29) reported AE’s. Of 29 included studies, AE’s were reported in 62,1 % (n=18) articles. Small to moderate AE’s (n=98) covered 82,4 % of all AE’s (n=119). Serious AE’s covered 15,9 % of all AE’s and lethal AE’s covered 1,7 % of all AE’s, however all AE’s were not associated to interventions. Pain was registered as most common AE corresponding 49,6 % of all AE’s. The second most common AE’s were musculoskeletal injuries corresponding 22,6 %. The reporting of AE’s was heterogenic and deficient making the implementation of meta-analysis not valid. All study articles had lacks, major lacks occurred in reporting the length and timing of AE’s. 82,8 % of articles reported only AE’s resulting from intervention and 55,2 % AE’s resulting dropouts, respectively.
Most of the AE’s were small to moderate suggesting exercise therapy interventions to be safe for OA patients. However, the study results should be used with caution because of heterogenic interventions and insufficient data. Considering the results of this study it’s suggested that the term “adverse event” be used in exercise therapy interventions, AE’s are reported by study arms and clearly indicated if AE’s were caused by intervention of not. Finally, the amount, intensity and duration of AE’s should be reported, and advantages and disadvantages of exercise treatment discussed.
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[{"key": "dc.contributor.advisor", "value": "Tarkka, Ina", "language": "", "element": "contributor", "qualifier": "advisor", "schema": "dc"}, {"key": "dc.contributor.author", "value": "Pennanen, Maria", "language": "", "element": "contributor", "qualifier": "author", "schema": "dc"}, {"key": "dc.date.accessioned", "value": "2019-06-19T08:50:12Z", "language": null, "element": "date", "qualifier": "accessioned", "schema": "dc"}, {"key": "dc.date.available", "value": "2019-06-19T08:50:12Z", "language": null, "element": "date", "qualifier": "available", "schema": "dc"}, {"key": "dc.date.issued", "value": "2019", "language": "", "element": "date", "qualifier": "issued", "schema": "dc"}, {"key": "dc.identifier.uri", "value": "https://jyx.jyu.fi/handle/123456789/64711", "language": null, "element": "identifier", "qualifier": "uri", "schema": "dc"}, {"key": "dc.description.abstract", "value": "Polvi- ja lonkkanivelrikko ovat yksi invalidisoivimmista ja eniten kipua aiheuttavista sairauksista. Liikunnalla on useita terveyshy\u00f6tyj\u00e4 polvi- ja lonkkanivelrikkoa sairastaville. Liikunnan hy\u00f6dyist\u00e4 nivelrikkopotilaille onkin tehty useita tutkimuksia, mutta haittoja ei ole tutkittu systemaattisesti. T\u00e4m\u00e4n systemaattisen kirjallisuuskatsauksen tarkoituksena on selvitt\u00e4\u00e4 haittojen vakavuutta, tyyppi\u00e4 ja insidenssi\u00e4 liikuntainterventiotutkimuksissa. Lis\u00e4ksi selvitet\u00e4\u00e4n miten ja kuinka usein haitat on raportoitu tutkimusartikkeleissa. \n\nArtikkelit haettiin systemaattisesti MEDLINE (via Pubmed), CENTRAL, PEDro, CINAHL ja SPORTDiscus tietokannoista sek\u00e4 harmaan kirjallisuuden WoS, Clinical trials.gov, ProQuest, OpenGrey sek\u00e4 ICTRP (WHO) tietokannoista lokakuussa 2015. Katsaukseen hyv\u00e4ksyttiin polvi- ja lonkkanivelrikkopotilaille tehdyt satunnaistetut, kontrolloidut liikuntainterventiotutkimukset sis\u00e4\u00e4notto- ja poissulkukriteerien mukaan ilman kieli- tai aikarajoituksia. \n\nSystemaattisella haulla l\u00f6ydettiin 5800 artikkelia, joista mukaan valittiin 75 artikkelia eri liikuntainterventiotutkimuksista. N\u00e4ist\u00e4 61,3 % ei raportoinut haitoista, joten lopulliseen tarkasteluun j\u00e4i 29 artikkelia. N\u00e4iss\u00e4 haittoja raportoitiin tapahtuneen 62,1 %:ssa (n=18). Kaikista haitoista (n=119) 82,4 % oli lievi\u00e4 tai kohtalaisia (n=98). Vakavia haittoja oli 15,9 % ja kuolemaan johtavia 1,7 %, mutta kaikki haitat eiv\u00e4t johtuneet interventiosta. Ilmenneist\u00e4 haitoista kipuoireet selittiv\u00e4t 49,6% ja TULE-vaivat 22,6 %. Haittojen raportointi oli heterogeenista ja riitt\u00e4m\u00e4t\u00f6nt\u00e4 niin haittojen m\u00e4\u00e4r\u00e4n, laadun kuin vakavuudenkin osalta ja kaikissa artikkeleissa oli haittojen raportointipuutteita. Artikkeleista 82,8 %:ssa oli raportoitu vain intervention aiheuttamat haitat ja 55,2 %:ssa vain keskeytt\u00e4miseen johtaneet haitat. Haittatietojen ker\u00e4\u00e4minen sek\u00e4 haittojen kesto ja ajoitus oli raportoitu erityisen heikosti. \n\nPolvi -ja lonkkanivelrikkopotilaille tehdyiss\u00e4 liikuntainterventiotutkimuksissa haitat olivat lievi\u00e4 tai kohtalaisia. Puutteellisen raportoinnin vuoksi tuloksiin tulee kuitenkin suhtautua varauksella. Katsauksen perusteella suositellaan, ett\u00e4 liikuntainterventiotutkimuksista kirjoitetuissa tutkimusartikkeleissa intervention aikaisista haitoista k\u00e4ytet\u00e4\u00e4n nimityst\u00e4 \u201dadverse event\u201d ja haitat raportoidaan tutkimusryhmitt\u00e4in. Lis\u00e4ksi haittojen m\u00e4\u00e4r\u00e4, vakavuus sek\u00e4 kesto tulee raportoida ja lopuksi m\u00e4\u00e4ritell\u00e4, johtuivatko mahdolliset haitat interventiosta vai eiv\u00e4t. Mik\u00e4li intervention aikana ilmenee haittoja, intervention sopeuttaminen, haittojen jatkotoimenpiteet sek\u00e4 n\u00e4iden vaikutukset yksil\u00f6lle tulisi kuvailla tutkimusartikkelissa.", "language": "fi", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.abstract", "value": "Osteoarthritis (OA) of the knee and hip is a common disease, leading to pain and disability. Exercise has many benefits and it has been widely recommended as treatment of OA. The advantages of exercise for knee and hip OA have been studied but adverse effects (AE\u2019s) for exercise interventions have not been systematically evaluated. The objective of this study is to define the frequency, type and incidence of AE\u2019s in exercise therapy interventions. Also, the quality of reporting AE\u2019s in exercise therapy study articles is being clarified. \n\nA systematic literature search was conducted in October 2015 in databases of MEDLINE (via Pubmed), CENTRAL, PEDro, CINAHL and SPORTDiscus. Also, a grey literature search was conducted in databases of WoS, Clinical trials.gov, ProQuest, OpenGrey and ICTRP (WHO). Studies of randomized controlled trials of exercise interventions for knee and hip OA was accepted according to inclusion and exclusion criteria. No restrictions of language or publication date were made. \n\n5800 articles were found with systematic review, of which 75 articles met the inclusion criteria. However, 61,3 % of studies (n=46) did not report AE\u2019s and were then excluded. 38,7 % of studies (n=29) reported AE\u2019s. Of 29 included studies, AE\u2019s were reported in 62,1 % (n=18) articles. Small to moderate AE\u2019s (n=98) covered 82,4 % of all AE\u2019s (n=119). Serious AE\u2019s covered 15,9 % of all AE\u2019s and lethal AE\u2019s covered 1,7 % of all AE\u2019s, however all AE\u2019s were not associated to interventions. Pain was registered as most common AE corresponding 49,6 % of all AE\u2019s. The second most common AE\u2019s were musculoskeletal injuries corresponding 22,6 %. The reporting of AE\u2019s was heterogenic and deficient making the implementation of meta-analysis not valid. All study articles had lacks, major lacks occurred in reporting the length and timing of AE\u2019s. 82,8 % of articles reported only AE\u2019s resulting from intervention and 55,2 % AE\u2019s resulting dropouts, respectively. \n\nMost of the AE\u2019s were small to moderate suggesting exercise therapy interventions to be safe for OA patients. However, the study results should be used with caution because of heterogenic interventions and insufficient data. Considering the results of this study it\u2019s suggested that the term \u201cadverse event\u201d be used in exercise therapy interventions, AE\u2019s are reported by study arms and clearly indicated if AE\u2019s were caused by intervention of not. Finally, the amount, intensity and duration of AE\u2019s should be reported, and advantages and disadvantages of exercise treatment discussed.", "language": "en", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Submitted by Paivi Vuorio (paelvuor@jyu.fi) on 2019-06-19T08:50:12Z\nNo. of bitstreams: 0", "language": "en", "element": "description", "qualifier": "provenance", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Made available in DSpace on 2019-06-19T08:50:12Z (GMT). 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