BACKGROUND AND PURPOSE To determine the effects of resistance training (RT) on symptoms, function, and lower limb muscle strength in patients with knee osteoarthritis (KOA), and to determine the optimal dose-response relationships. DATA SOURCES We searched the PubMed, MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and ClinicalTrials.gov databases from inception to January 23, 2022. ELIGIBILITY CRITERIA Randomized controlled trials that examined the effects of RT in KOA patients (mean age ≥50 years) were included. DATA SYNTHESIS We applied Hedges' g of the random-effects model to calculate the between-subject standardized mean difference (SMDbs). A random-effects metaregression was calculated to explain the influence of key training variables on the effectiveness of RT. We used the Grading of Recommendations Assessments, Development and Evaluation (GRADE) method to appraise the certainty of evidence. RESULTS A total of 46 studies with 4289 participants were included. The analysis revealed moderate effects of RT on symptoms and function (SMDbs =-0.52; 95% CI: -0.64 to -0.40), and lower limb muscle strength (SMDbs = 0.53; 95% CI: 0.42 to 0.64) in the intervention group compared with the control group. The results of the metaregression revealed that only the variable "training period" (P< .001) had significant effects on symptoms, function, and lower limb muscle strength, and the 4 to 8 weeks of training subgroup showed greater effects than other subgroups (SMDbs =-0.70, -0.91 to -0.48; SMDbs = 0.76, 0.56 to 0.96). CONCLUSIONS Compared with inactive treatments, RT is strongly recommended to improve symptoms, function, and muscle strength in individuals with KOA. Dose-response relationship analysis showed that 4 to 8 weeks of RT had more benefits.

中文翻译：

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成人膝骨关节炎阻力训练的剂量-反应关系：系统评价和荟萃分析。

背景和目的 确定阻力训练 (RT) 对膝骨关节炎 (KOA) 患者症状、功能和下肢肌肉力量的影响，并确定最佳剂量反应关系。数据来源 我们检索了 PubMed、MEDLINE、Embase、Cochrane 对照试验中央注册库 (CENTRAL)、Web of Science 和 ClinicalTrials.gov 数据库，从建库到 2022 年 1 月 23 日。 资格标准 随机对照试验，检验放疗在KOA 患者（平均年龄≥50 岁）包括在内。数据综合我们应用随机效应模型的 Hedges g 来计算受试者间标准化平均差 (SMDbs)。计算随机效应元回归来解释关键训练变量对 RT 有效性的影响。我们使用建议评估、制定和评估分级（GRADE）方法来评估证据的确定性。结果 总共纳入了 46 项研究，涉及 4289 名参与者。分析显示，干预组中放疗对症状和功能（SMDbs =-0.52；95% CI：-0.64 至 -0.40）以及下肢肌肉力量（SMDbs = 0.53；95% CI：0.42 至 0.64）有中等影响与对照组相比。元回归结果显示，只有变量“训练时间”（P< .001）对症状、功能和下肢肌肉力量有显着影响，并且训练 4 至 8 周的亚组比其他亚组表现出更大的影响（ SMDbs =-0.70、-0.91 至 -0.48；SMDbs = 0.76、0.56 至 0.96）。结论 与非积极治疗相比，强烈建议放疗可改善 KOA 患者的症状、功能和肌肉力量。剂量反应关系分析表明，4 至 8 周的 RT 具有更多益处。