patmedfarПациентоориентированная медицина и фармацияPatient-Oriented Medicine and Pharmacy2949-1924LLC Izdatelstvo OKI10.37489/2949-1924-0056AYKRDIpatmedfar-100Research ArticleФИЗИЧЕСКАЯ И РЕАБИЛИТАЦИОННАЯ МЕДИЦИНАPHYSICAL AND REHABILITATION MEDICINEВлияние физической реабилитации на восприятие боли и функциональные возможности людей с остеоартритомEffects of physical rehabilitation on pain perception and functional capabilities in individuals with osteoarthritishttps://orcid.org/0000-0002-1737-7328ПлещёвИ. Е.PleshchevI. E.

Плещёв Игорь Евгеньевич — к. м. н., старший  преподаватель кафедры физической культуры и спорта

Ярославль

Igor E. Pleshchev — Cand. Sci. (Med.), senior lecturer of the Department of Physical Culture and Sports

Yaroslavl

doctor.pleshyov@gmail.comhttps://orcid.org/0000-0001-9532-9957НиколенкоВ. Н.NikolenkoV. N.

Николенко Владимир Николаевич — д. м. н.,профессор, зав. кафедрой анатомии и гистологиичеловека; зав. кафедрой нормальной анатомии с курсом топографической анатомии и оперативной хирургии Факультета фундаментальной медицины

Москва

Vladimir N. Nikolenko — Dr. Sci. (Med.), Professor, Head of the Department of Human Anatomy, N. V.  Sklifosovsky Institute of Clinical Medicine, Head of the Department of Normal Anatomy with a course in Topographic Anatomy and Operative Surgery Fundamental Medicine Faculty

Moscow

vn.nikolenko@yandex.ruhttps://orcid.org/0000-0001-9964-5199АчкасовЕ. Е.AchkasovE. E.

Ачкасов Евгений Евгеньевич — д. м. н., профессор, зав. кафедрой спортивной медицины и медицинской реабилитации

Москва

Evgeny E. Achkasov — Dr. Sci. (Med.), Professor, Head of the Department of Sports Medicine and Medical Rehabilitation, N. V. Sklifosovsky Institute of Clinical Medicine

Moscow

2215.g23@rambler.ruhttps://orcid.org/0000-0002-0234-0768ШкребкоА. Н.ShkrebkoA. N.

Шкребко Александр Николаевич — д. м. н., профессор, зав. кафедрой медицинской реабилитации и  спортивной медицины

Ярославль

Aleksandr N. Shkrebko — Dr. Sci. (Med.), Professor, Head of the Department of Medical Rehabilitation and Sports Medicine

Yaroslavl

anshkrebko@mail.ruhttps://orcid.org/0000-0003-0730-347XСтрижковА. Е.StrizhkovA. E.

Стрижков Алексей Евгеньевич — к. м. н., доцент кафедры анатомии и гистологии человека

Москва

Alexey E. Strizhkov — Cand. Sci. (Med.), Associate  Professor of the Department of Human Anatomy and Histology

Moscow

strizhkov_a_e@staff.sechenov.ruhttps://orcid.org/0009-0007-2454-989XСолдатоваО. Н.SoldatovaO. N.

Солдатова Ольга Николаевна — к. м. н., главный врач

Сергиев Посад, Московская область

Olga N. Soldatova — Cand. Sci. (Med.), The chief physician of the Sanatorium Buran — branch of the joint stock company Russian Railways-Health

Moscow region, Sergiev Posad district

soldatovaon13@gmail.comhttps://orcid.org/0000-0002-7343-7655КудрявцеваВ. А.KudryavtsevaV. A.

Кудрявцева Варвара Алексеевна — студент Института клинической медицины им. Н. В. Склифосовского

Москва

Varvara A. Kudryavtseva — student of the N. V.  Sklifosovsky Institute

kudryavtseva_v_a@student.sechenov.ruФГБОУ ВО «Ярославский государственный медицинский университет»РоссияYaroslavl State Medical University, YaroslavlRussian FederationФГАОУ ВО «Первый Московский государственный медицинский университет имени И. М. Сеченова» (Сеченовский Университет); ФГБОУ ВО «Московский государственный университет имени М. В. Ломоносова»РоссияSechenov First Moscow State Medical University (Sechenov University); Moscow State University named after M. V. LomonosovRussian FederationФГАОУ ВО «Первый Московский государственный медицинский университет имени И. М. Сеченова» (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian FederationФГБОУ ВО «Ярославский государственный медицинский университет»РоссияYaroslavl State Medical UniversityRussian FederationСанаторий «Буран» АО «РЖД-Здоровье»РоссияSanatorium Buran - branch of the joint stock company Russian Railways-HealthRussian Federation202401112024232936Copyright © Плещёв И.Е., Николенко В.Н., Ачкасов Е.Е., Шкребко А.Н., Стрижков А.Е., Солдатова О.Н., Кудрявцева В.А., 20242024Плещёв И.Е., Николенко В.Н., Ачкасов Е.Е., Шкребко А.Н., Стрижков А.Е., Солдатова О.Н., Кудрявцева В.А.Pleshchev I.E., Nikolenko V.N., Achkasov E.E., Shkrebko A.N., Strizhkov A.E., Soldatova O.N., Kudryavtseva V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.pomph.ru/jour/article/view/100

Реабилитация широко рекомендована в национальных и международных руководствах по лечению остеоартрита (ОА) и считается одним из основных методом лечения пациентов с ОА. Реабилитация при остеоартрите включает в себя физические упражнения, силовые тренировки, контроль собственного веса, обучение  самоконтролю, а также переход к активному образу жизни.

Проведён обзор эффективности и безопасности реабилитации при лечении ОА и проанализированы международные рекомендации, основанные на фактических данных. Лечебная физкультура (ЛФК) широко рекомендуется для лечения ОА, в данном обзоре мы сосредоточились на упражнениях на суше и воде, а также на силовых тренировках при ОА. В целом, данные свидетельствуют о том, что ЛФК и специальные укрепляющие упражнения или силовые тренировки для нижних конечностей уменьшают боль и улучшают физическую функцию при ОА коленного сустава. Данные о других локализациях ОА менее достоверны. Поэтому, из-за отсутствия специальных исследований, рекомендации по лечению ОА тазобедренного сустава и кистей рук в основном основаны на исследованиях ОА коленного сустава. Кроме того, не было разработано конкретных рекомендаций относительно режима физических упражнений. Эффективность и безопасность ЛФК и силовых тренировок необходимо дополнительно оценить в рандомизированных контролируемых исследованиях с участием пациентов с ОА тазобедренного сустава и кистей рук. Необходимо также более чётко определить оптимальный состав программ упражнений.

В PubMed и Cochrane Database был проведён поиск соответствующей литературы, за период c 2014 по 1 марта 2024 года. Критерии исключения: отсутствие групп сравнения; общее число участников исследований <20 и преждевременное прекращение исследования.

Rehabilitation is widely recommended in national and international guidelines for the treatment of osteoarthritis (OA) and is considered one of the main treatment strategies for patients with OA. Osteoarthritis rehabilitation includes physical exercise, strength training, weight-control, and self-control training and includes transitioning to an active lifestyle.

A review of the effectiveness and safety of rehabilitation for the treatment of OA was conducted, and international evidence-based recommendations were analyzed. Physical therapy is widely recommended for the treatment of OA. In this review we focused on exercises on land and water, and strength training for OA. In general, evidence indicates that physical therapy and special strengthening exercises or strength training for the lower extremities can reduce pain and improve physical function in knee joint OA. Data from other OA localities are less reliable. Therefore, considering the lack of special studies, recommendations for treating hip and hand OA are based on studies on knee OA. In addition, no recommendations regarding the exercise regime have been developed. The effectiveness and safety of physical therapy and strength training should be further evaluated in randomized controlled trials involving patients with OA of the hip joint and hands. It is also necessary to define the optimal composition of exercise programs more clearly.

A search of relevant literature was conducted in PubMed and the Cochrane Database from 2014 to March 1, 2024. Exclusion criteria: absence of comparison groups; total number of study participants <20 and premature termination of the study.

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The authors declare that there are no conflicts of interest present.