Preventive and therapeutic intervention in osteoarthritis: systematic review of the literature.
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Abstract
Introduction and Objective
Osteoarthrosis (OA) is characterized by degeneration of cartilage that causes structural and functional failure of the synovial joints, mainly through a regressive and non-inflammatory alteration of the cartilage. This pathology is one of the leading causes of disability worldwide, largely due to pain. The objective of this study is to perform a systematic review, comparing the effectiveness of the various rehabilitation therapies proposed for this pathology, also studying the importance of prevention in the exposed subjects and highlight treatment interventions that benefit to patients.
Materials and Methods
The literature research was conducted following the international PRISMA guidelines through the PICO strategy; it was carried out through the databases Medline (via PubMed), Scopus, LILACS, Trip Database and Pedro between May-June 2023. The present literature has been examined through the formulation of several research strings: PubMed ((“Osteoarthrosis” [MeSH]) AND (“physiotherapy” [MeSH] OR (“rehabilitation” [MeSH] OR (“exercise” [MeSH])), Scopus, LILACS and Trip Database (“Osteoarthrosis” AND (“physiotherapy” OR “rehabilitation” OR “ exercise”)). On PEDro the string "Osteoarthrosis AND Rehabilitation" was used. Only RCT studies in English, published from 2013 to 2023, which treated the lower limb in patients aged between 55 and 70 years, were included. Duplicate items hav been deleted using EndNote software. Firstly, relevant articles were selected based on title and abstract, and finally on full text.
Results
After inclusion, 6 RCTs were selected with a population affected by osteoarthritis of the lower limbs, and methodological quality was assessed through the PEDro scale. The articles had an average score of 7,3. We looked at many treatment strategies: aerobic training, hip muscle stretching exercises, static and dynamic balance exercises, stability and resistance exercises, electrotherapy, but it was found that the majority of the included studies used muscle strengthening exercise.
Discussion and Conclusion
Through the results obtained from this Systematic Review, it is considered necessary to recognize the rehabilitation interventions, through their multidisciplinary dimension, a fundamental part of the treatment, as important as the pharmacological intervention, to determine a slowdown in the progression of the pathology and an effective control of the osteoarthritis. The analysis leads us to state that it would be necessary to expand the research through long-term follow-up and increase the sample size.
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