關節運動對類風濕性關節炎病人疼痛控制之療效：系統性文獻回顧

Therapeutic effect of exercise on pain control in patients for rheumatoid arthritis: A systematic review

本文旨在瞭解關節運動之介入措施，對類風濕性關節炎病人疼痛控制之影響。本研究搜尋2003年至2015年4月之中、英文文獻，中文資料庫為華藝線上圖書館及台灣博碩士論文網，西文資料庫包含CINAHL、PubMed、Google Scholar、Cochrane library、Medline、Joanna Briggs Institute(JBI)等，以PICO(patient,intervention, comparison,outcome)建立中、英文關鍵字，分別為P：類風溼性關節炎(rheumatoid arthritis)，I：關節運動(joint exercise)，C：常規護理(routine care)，O：疼痛(pain)，並運用布林邏輯運算，同義字間以or聯結，關鍵字間再以and交集。經過文章篩選及品質評價，最後共納入隨機對照試驗7篇，與非隨機對照試驗2篇，共1,121位類風溼性關節炎病人，採手部等張與等長運動及其他上肢運動訓練，如舉啞鈴，運動前後須做熱 身及緩和活動，運動訓練計畫為期6-36週不等能降低疼痛，故臨床上針對此類病人建議執行等張及等長之四肢運動至少6週以上，未來研究建議著重於隨機對照及盲化之研究設計，以驗證此結果。

The purpose of this study was to evaluate the therapeutic effect of joint exercise on pain control of rheumatoid arthritis patients. A comprehensive search of the AiritiArieti library, the National digital library of theses and dissertations in Taiwan, CINAHL, PubMed, Google Scholar, the Cochrane library, Medline and Joanna Briggs Institute (JBI) was conducted for English and Chinese studies from 2003 to 2015 over four4 -months . PICO (patient, intervention, comparison, outcomeand outcome) method was performed with Boolean search for keywords as followsing, P: rheumatoid arthritis, I: joint exercise, C: usual care, O: pain. After article screening and quality appraisal, seven randomized controlled trials and two clinical controlled trials were included in this study. A total of 1,121 rheumatoid arthritis patients reported reduced pain after the exercise program. The training courses included isotonics, isometric exercise of hands, and other arm movements such as lifting dumbbells. Warm-up and cool-down exercises had to must be done before and after the course. The program period ranged from 6 to 36 weeks. In clinical applications, it is recommended that patients with rheumatoid arthritis receive joint exercise for at least six weeks. Further researches with rigid design of randomization and blindness are also encouraged to verify this result.