强直性脊柱炎患者运动指导方案的最佳证据总结

doi:10.3761/j.issn.0254-1769.2023.07.014

摘要/Abstract

摘要：

目的总结强直性脊柱炎患者运动指导方案的最佳证据，为对强直性脊柱炎患者实施运动指导提供依据。方法计算机系统检索UpToDate、BMJ最佳临床实践、OVID、CINAHL、Cochrane Library、Embase、PubMed、Scopus、中国知网、万方数据库、维普数据库、中国生物医学文献数据库、医脉通等指南网及专业协会网站和数据库中关于强直性脊柱炎患者运动方案的指南、系统评价、Meta分析、专家共识、证据总结、最佳临床实践等，检索时限为2012年1月1日—2022年1月1日，由2名护士独立对文献进行筛选、质量评价、提取最佳证据并分级，总结运动指导方案的最佳证据。结果共纳入文献16篇，包括指南1篇、系统评价6篇、Meta分析4篇、专家共识5篇，总结出运动指导方案的最佳证据包括运动前评估、运动适用范围、不同疾病阶段分期的运动类型、运动项目内容（项目、内容、运动强度、频率、周期）、监督方式、运动监测指标、运动风险评估、注意事项共8个方面，39条证据。结论该研究总结的强直性脊柱炎患者运动指导方案的最佳证据，规范了强直性脊柱炎患者康复运动的理论、实践，形成科学、规范、基于最佳证据的运动指导方案。

关键词: 强直性脊柱炎, 自身免疫疾病, 运动, 最佳证据, 康复护理, 循证护理学

Abstract:

Objective To summarize the best evidence of exercise guidance programs for patients with ankylosing spondylitis based on the evidence，and to provide the basis for exercise therapy for patients with ankylosing spondylitis. Methods The computer system retrieved UpToDate，BMJ，OVID，CINAHL，Cochrane，Embase，Pubmed，Scopus，CNKI，Wanfang Database，Chongqing VIP，China Biomedical Database，Yimaitong and other guidelines on exercise programs for patients with ankylosing spondylitis，systematic reviews，Meta-analysis，expert consensuses，evidence summaries，randomized controlled trials，etc. The retrieval time was from January 1，2021 to January 1，2022. There were 2 nurses who independently screened the literature，evaluated the quality，and extracted the best literature，evidence and grading，and then summarized the best evidence for exercise guidance programs. Results A total of 16 articles，involving 1 guideline，6 systematic reviews，4 meta-analyses，and 5 expert consensus articles，were included. The best evidence for exercise guidance programs was summarized. There are 38 pieces of evidence in a total of 7 aspects，including pre-exercise evaluation，scope of exercise，exercise in different stages，sports content （project，exercise intensity，frequency，period），sports monitoring indicators，sports risk assessment and related precautions. Conclusion Based on the best evidence of ankylosing spondylitis exercise guidance programs summarized by evidence-based nursing，this study standardizes the theory and practice of rehabilitation exercise for patients with ankylosing spondylitis，and forms a scientific，standardized exercise guidance program with the best evidence.

Key words: Ankylosing Spondylitis, Autoimmune Diseases, Exercise, Best Evidence, Rehabilitation Nursing, Evidence-Based Nursing

马喜宁, 白艳娟, 孔思铭, 黄蓉, 张静, 姚辉. 强直性脊柱炎患者运动指导方案的最佳证据总结[J]. 中华护理杂志, 2023, 58(7): 864-870.

MA Xining, BAI Yanjuan, KONG Siming, HUANG Rong, ZHANG Jing, YAO Hui. Summary of the best evidence on exercise guidance programs for patients with ankylosing spondylitis[J]. Chinese Journal of Nursing, 2023, 58(7): 864-870.

图/表 5

图1 文献筛选流程图

Figure 1 Flow chart of literature screening

表1 纳入文献的基本特征（n=16）

Table 1 Characteristics of included studies（n=16）

表2 纳入系统评价和Meta分析的质量评价结果（n=10）

Table 2 Quality evaluation results of systematic reviews and meta-analysis（n=10）

表3 专家共识评价结果（n=5）

Table 3 Quality evaluation results of expert consensuses（n=5）

表4 强直性脊柱炎患者运动指导方案最佳证据总结

Table 4 Summary of the best evidence of exercise guidance programs in patients with ankylosing spondylitis

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