保持活跃以维护关节健康 资料

本页面由机器翻译,尚未经临床医生审核。英文版本为权威版本。

您的感受

您可能注意到,在活动后关节会感到僵硬或酸痛。这种不适常在夜间或清晨刚醒来时加重。简单的日常活动可能会变得困难。您可能难以将手伸到背后扣上胸罩。将衬衫塞进裤子里也可能感到别扭或疼痛。

运动有助于管理这些症状。如果您在人工全膝关节置换术后 12 周内开始运动计划,您很可能会看到活动能力的改善。这些早期努力侧重于功能表现。如果您继续运动超过 12 周,您将增强肌肉力量并提高关节灵活性。

对于患有膝关节磨损性关节炎的患者,有氧运动可以改善心肺功能。运动也可能有助于减轻疼痛并改善功能,尽管受益程度因人而异。重要的是要知道,使用可穿戴设备自我监测活动并不会改变您对关节功能或整体健康的感受。

在某些情况下,例如扳机指,夹板和运动可提供短期缓解。对于腕骨关节炎,运动计划可能有助于长期管理症状,且在两年内只有极少数人需要手术。虽然这些运动有帮助,但手部或肘部疾病的大多数结果差异可能未达到对您而言具有临床重要意义的改变水平。

您的外科医生将指导您进行适当类型和数量的活动。目标是在尊重您身体极限的同时,确保您安全地活动。倾听您的关节。如果某项活动引起剧烈疼痛,请停止并休息。持续、温和的运动通常比强忍不适继续活动更好。

实际发生的情况

您的关节被设计为能够顺畅运动。软骨就像骨骼末端的减震器或光滑涂层。当这种组织磨损时,如骨关节炎,关节会变得僵硬和疼痛。这种磨损过程会降低您自由活动的能力。

运动有助于管理这些变化。对于膝骨关节炎患者,有氧运动可以改善心肺适能。这意味着您的心脏和肺部在运动期间工作得更高效。规律的活动还可以帮助减轻疼痛并改善功能,尽管改善程度各不相同。

关节置换术后,时机很重要。如果您在膝关节置换术后 12 周内开始运动干预,您主要会看到功能表现的改善。这有助于您恢复日常任务。如果这些运动干预在膝关节置换术后持续超过 12 周,您将获得更大的肌肉力量和关节灵活性收益。更强的肌肉能更好地支撑关节,从而减轻对磨损软骨的压力。

对于其他关节,证据不一。使用可穿戴活动追踪器进行自我监测的身体活动对髋部和膝骨关节炎患者的感知关节功能或健康相关生活质量没有任何影响。同样,针对手、腕或肘部疾病的肩胛运动计划中,大多数功能结果的差异未达到被认为具有临床重要性的最低阈值。

在某些情况下,如扳机指,近端指间关节支具和治疗性运动显示出可行性和短期临床改善。然而,由于缺乏对照组,这不能确立其优于其他保守治疗。对于腕骨关节炎,在一项关于神经肌肉运动疗法的随机对照试验中,两组中在 24 个月时只有少数参与者需要手术。这表明运动计划可能有助于随着时间的推移管理症状。

您的外科医生可能不会仅因严重髋骨关节炎症状而优先考虑全髋关节置换术结果,尽管这需要在试验中确认。目标是通过运动保持您的活动能力并管理症状,根据您的特定关节和状况进行定制。

预期效果

您迈向更好关节健康的旅程在很大程度上取决于您开始运动的时机和方式。如果您接受了全膝关节置换术,在术后12周内开始锻炼有助于恢复日常功能。如果持续进行这些锻炼超过12周,您将看到肌肉力量和关节灵活性的更大提升。这种循序渐进的方法能为您的新关节提供所需的支撑,使其更持久耐用。

对于管理膝关节磨损性关节炎的患者,规律的有氧运动可改善心肺功能。您可能还会注意到疼痛减轻和活动能力改善。然而,目前的证据尚不足以保证这些改变对每个人来说都是一次重大的生活改善。这是一种有益的工具,但效果因人而异。

如果您正在考虑全髋关节置换术,请不要等到症状严重才行动。虽然目前的数据支持这一观点,但仍需通过临床试验进一步证实。早期干预通常能带来更顺利的结果。

您可能会想知道,记录步数是否会改变您的预期。使用可穿戴活动追踪器监测您的运动情况,并不能改善您对关节功能或整体生活质量的感受。数据显示,这种自我监测对髋关节和膝关节关节炎患者没有显著益处。

对于其他关节,如手、腕或肘部,锻炼计划的效果不一。肩胛骨(肩胛)锻炼带来的大多数日常功能改善未达到具有临床重要意义的阈值。同样,虽然矫形器和锻炼在短期内有助于治疗扳机指,但尚未被证明优于其他保守治疗方法。

在腕骨关节炎的情况下,遵循神经肌肉锻炼计划的患者在24个月时仅有少数人需要手术。这表明,持续的锻炼有助于长期管理症状,并可能延缓或避免手术干预。您的外科医生将根据您的具体关节和症状,帮助您选择正确的治疗路径。


Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Exercise interventions implemented ≤12 weeks after total knee arthroplasty primarily improve functional performance [1].
  • Exercise interventions lasting >12 weeks after total knee arthroplasty result in greater gains in muscle strength and joint flexibility [1].
  • Total hip arthroplasty outcomes should not be prioritized only for patients with severe hip osteoarthritis symptoms, though confirmation in a trial is required [2].
  • Aerobic exercise elicits improvements in cardiopulmonary fitness for people with knee osteoarthritis [3].
  • Exercise may improve pain and function in knee osteoarthritis with low to moderate certainty, but it is uncertain whether these differences are clinically important [5].
  • Self-monitoring physical activity with wearable activity trackers does not have any effect on perceived joint function or health-related quality of life in people with hip and knee osteoarthritis [7].
  • Scapular exercise programs for hand, wrist, or elbow disorders result in functional outcome differences that most often do not reach the minimum threshold to be considered clinically important [8].
  • Proximal interphalangeal joint orthosis and therapeutic exercise demonstrate feasibility and short-term clinical improvement for trigger finger, but cannot establish superiority over other conservative treatments due to the absence of a control group [9].
  • Neuromuscular exercise therapy contributes to symptom management in wrist osteoarthritis over time, with few participants requiring surgical conversion at 24 months [10].

How It Works

  • Exercise may improve pain and function in knee osteoarthritis with low to moderate certainty [5].
  • It is uncertain whether the improvements in pain and function from exercise for knee osteoarthritis are clinically important [5].
  • The addition of wearable activity tracker use did not have any effect on perceived joint function or health-related quality of life in people with hip and knee osteoarthritis [7].
  • Most differences in functional outcomes from scapular exercise programs for hand, wrist, or elbow disorders did not reach the minimum threshold to be considered clinically important [8].
  • Proximal interphalangeal joint orthosis and therapeutic exercise demonstrate feasibility and short-term clinical improvement for trigger finger management [9].
  • Few participants in either group required surgery at 24 months in a trial of neuromuscular exercise therapy for wrist osteoarthritis, indicating that exercise programs may contribute to long-term symptom management [10].
  • The addition of whole-body vibration to exercise therapy led to greater improvements in several outcomes for end-stage knee osteoarthritis, suggesting it may optimize the benefits of exercise therapy [12].
  • Moderate treadmill exercise following an initial period of short-term immobilization has a positive impact on tendon-bone interface healing after anterior cruciate ligament reconstruction [13].
  • Prolonged immobilization has a detrimental effect on physical recovery following anterior cruciate ligament reconstruction [13].
  • Pain science education may act as a mechanism of action for exercise interventions in people with knee or hip osteoarthritis [14].
  • Pain science education is less successful when delivered standalone compared to when it is part of an exercise intervention [14].
  • There is heterogeneity in functional recovery among joint arthroplasty patients, highlighting the importance of a personalised, data-driven approach to post-operative care [15].

What the Evidence Shows

  • Findings question whether total hip arthroplasty should be prioritized only for patients with severe hip osteoarthritis symptoms, though confirmation in a trial is required [2].
  • Most differences in functional outcomes for patients with hand, wrist, or elbow disorders following a scapular exercise program did not reach the minimum threshold to be considered clinically important [8].
  • Proximal interphalangeal joint orthosis and therapeutic exercise demonstrate feasibility and short-term clinical improvement for trigger finger management, but cannot establish superiority over other conservative treatments due to the absence of a control group [9].
  • Few participants in either group required surgery at 24 months in a randomized controlled trial of neuromuscular exercise therapy for wrist osteoarthritis, indicating that exercise programs may contribute to long-term symptom management [10].
  • The document for Fu’s subcutaneous needling versus bracing combined with exercise therapy is a study protocol and does not report results or conclusions [11].
  • The addition of whole-body vibration to exercise therapy led to greater improvements in several outcomes for end-stage knee osteoarthritis, suggesting it may be a valuable adjunct to optimize exercise benefits [12].
  • Moderate treadmill exercise following an initial period of short-term immobilization has a positive impact on tendon-bone interface healing after anterior cruciate ligament reconstruction in a murine model [13].
  • Prolonged immobilization has a detrimental effect on physical recovery following anterior cruciate ligament reconstruction in a murine model [13].
  • Pain science education may act as a mechanism of action for exercise interventions in people with knee or hip osteoarthritis, and is less successful when delivered standalone [14].
  • An individually tailored, supervised prehabilitation program resulted in superior improvements in perceived knee function compared to a self-administered program before anterior cruciate ligament reconstruction [16].
  • Both combined mode kinetic chain exercises with core strengthening and combined kinetic chain exercise only reduced pain, improved knee flexion and extension, and improved overall quality of life in patients with knee osteoarthritis [17].
  • Progressive tendon-loading eccentric exercise therapy in athletes with patellar tendinopathy resulted in statistically significant decreases in center of pressure velocity and increases in Y-Balance Test reach distances compared to baseline [18].
  • Mobile game-based home exercise programs may be a potentially effective option for thumb rehabilitation, with significantly higher adherence observed compared to standard home exercise programs [19].
  • Ankle pump exercises significantly reduce the incidence of deep vein thrombosis and increase venous haemodynamic parameters—specifically maximum venous outflow and maximum venous capacity—in patients undergoing lower limb orthopaedic surgery [20].
  • There is moderate-certainty evidence that Pilates and Tai Chi may be the most effective mind–body exercises for improving pain and physical function in knee osteoarthritis [21].
  • Tai Chi may be the best mind–body exercise for improving quality of life in knee osteoarthritis [21].

Practical Considerations

  • Total hip arthroplasty should not necessarily be prioritized only for patients with severe hip osteoarthritis symptoms, although this requires confirmation in a trial [2].
  • Few participants in either group required surgery at 24 months in a randomized controlled trial of neuromuscular exercise therapy for wrist osteoarthritis, indicating that exercise programs may contribute to symptom management over time [10].
  • The addition of whole-body vibration to exercise therapy led to greater improvements in several outcomes for end-stage knee osteoarthritis, suggesting it may be a valuable adjunct to optimize the benefits of exercise therapy [12].
  • Heterogeneity in functional recovery among joint arthroplasty patients underscores the importance of a personalized, data-driven approach to post-operative care to optimize long-term outcomes [15].

Key Evidence

  • [L1] The interventions implemented at ≤12 weeks primarily improved the functional performance, whereas those lasting >12 weeks resulted in greater gains in the muscle strength and joint flexibility. [1] (10.1186/s13018-025-06430-7)
  • [L3] These findings question whether THA should be prioritized only for those patients who have severe hip OA symptoms, but require confirmation in a trial. [2] (10.1016/j.arth.2025.04.032)
  • [L1] These results support the hypothesis that aerobic exercise can elicit improvements in cardiopulmonary fitness for people with knee OA. [3] (10.1186/s12891-025-08746-1)
  • [L1] Exercise may improve pain and function with low to moderate certainty, but it is uncertain whether differences are clinically important. [5] (10.1097/corr.0000000000003476)
  • [L1] The addition of WAT-use did not have any effect on perceived joint function or HRQoL. [7] (10.1186/s12891-024-08238-8)
  • [L1] However, most of these differences did not reach the minimum threshold to be considered clinically important. [8] (10.1016/j.jht.2024.07.006)
  • [L4] Because of the absence of a control group, these findings demonstrate feasibility and short-term clinical improvement but cannot establish superiority over other conservative treatments. [9] (10.1016/j.jhsg.2026.101038)
  • [L1] Nevertheless, few participants in either group required surgery at 24 months, indicating that both exercise programs may contribute to symptom management over time. [10] (10.1186/s12891-025-09463-5)
  • [Paper] This document is a study protocol outlining the design of a randomized controlled trial to compare Fu's subcutaneous needling with bracing combined with exercise therapy; it does not report results or conclusions. [11] (10.1186/s13018-026-06719-1)
  • [L3] The addition of WBV to exercise therapy led to greater improvements in several outcomes, suggesting that WBV may be a valuable adjunct to optimize the benefits of exercise therapy. [12] (10.1186/s42836-025-00301-6)
  • [L5] Moderate treadmill exercise following an initial period of short-term immobilization has a positive impact on tendon-bone interface healing, whereas prolonged immobilization has a detrimental effect on physical recovery. [13] (10.1177/2325967125s00320)
  • [L1] PSE may act as a mechanism of action for exercise interventions, and is less successful delivered standalone. [14] (10.1186/s12891-025-09313-4)
  • [L3] The findings highlight heterogeneity in functional recovery and underscore the importance of a personalised, data-driven approach to post-operative care to optimise long-term outcomes. [15] (10.1186/s42836-025-00339-6)
  • [L1] An individually tailored, supervised prehabilitation program resulted in superior improvements in perceived knee function compared to a self-administered program. [16] (10.1177/2325967126s00041)
  • [L2] The study concluded that both the experimental group receiving core strengthening exercises with combined mode kinetic chain exercises and the control group receiving combined kinetic chain exercise only reduced pain, improved knee flexion and extension, and improved the overall quality of life of patients with knee Osteoarthritis. [17] (10.1186/s12891-026-09531-4)
  • [L2] The intervention group showed statistically significant decreases in center of pressure velocity and increases in Y-Balance Test reach distances compared to baseline. [18] (10.1016/j.jisako.2026.101105)
  • [L2] Mobile game-based home exercise programs may be considered a potentially effective option in thumb rehabilitation and, at the very least, not inferior to standard home exercise programs, with significantly higher adherence to home exercises observed in the mobile game group. [19] (10.1177/17589983251387079)
  • [L1] This meta-analysis provides Level I evidence that ankle pump exercises significantly reduce the incidence of deep vein thrombosis (DVT) and increase venous haemodynamic parameters—specifically maximum venous outflow (MVO) and maximum venous capacity (MVC)—in patients undergoing lower limb orthopaedic surgery. [20] (10.1186/s13018-025-06236-7)
  • [L1] There is moderate-certainty evidence that Pilates and Tai Chi may be the most effective mind–body exercises for improving pain and physical function in knee osteoarthritis, while Tai Chi may be the best for improving quality of life. [21] (10.1186/s13018-025-05682-7)

References

[1] Changes in knee outcome measures following later-stage exercise interventions implemented ≤ 12 weeks vs. > 12 weeks after total knee arthroplasty: a systematic review and meta-analysis. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06430-7

[2] Total Hip Arthroplasty versus Education and Exercise: A Secondary Analysis of Propensity Matched Data Comparing Outcomes Across Hip Osteoarthritis Symptom Severity. The Journal of Arthroplasty. 2025. DOI: 10.1016/j.arth.2025.04.032

[3] Effect of aerobic exercise on cardiopulmonary fitness among people with knee osteoarthritis: a systematic review and meta-analysis. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-08746-1

[5] Cochrane in CORR®: Exercise for Osteoarthritis of the Knee. Clinical Orthopaedics & Related Research. 2025. DOI: 10.1097/corr.0000000000003476

[7] Effects of self-monitoring physical activity with wearable activity trackers on perceived joint function and health-related quality of life in people with hip and knee osteoarthritis: a secondary analysis of a cluster-randomised clinical trial. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-024-08238-8

[8] Effectiveness of a scapular exercise program on functional outcomes in patients with hand, wrist or elbow disorders: A comprehensive systematic review with meta-analysis. Journal of Hand Therapy. 2025. DOI: 10.1016/j.jht.2024.07.006

[9] Effectiveness of Proximal Interphalangeal Joint Orthosis and Therapeutic Exercise in the Management of Trigger Finger: A Prospective Case Series. Journal of Hand Surgery Global Online. 2026. DOI: 10.1016/j.jhsg.2026.101038

[10] Long-term effects of neuromuscular exercise therapy and the need for surgical conversion in wrist osteoarthritis: 24-month results from a randomized controlled trial. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-09463-5

[11] Fu’s subcutaneous needling versus bracing combined with exercise therapy in the treatment of postacute lateral ankle sprain and the prevention of chronic ankle instability: a randomized controlled trial protocol. Journal of Orthopaedic Surgery and Research. 2026. DOI: 10.1186/s13018-026-06719-1

[12] Improving pain, function and quality of life in end-stage knee osteoarthritis: a patient-preference cohort study on whole-body vibration and exercise as bridging therapies for total knee replacement. Arthroplasty. 2025. DOI: 10.1186/s42836-025-00301-6

[13] Poster 234: Improvement of Tendon-Bone Interface Healing by Moderate Treadmill Exercise Combined with Knee Brace Immobilization Following an Anterior Cruciate Ligament Reconstruction in a Murine Model. Orthopaedic Journal of Sports Medicine. 2025. DOI: 10.1177/2325967125s00320

[14] Pain science education and exercise interventions for people with knee or hip osteoarthritis: a systematic review, content and meta-analysis. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-09313-4

[15] Unsupervised machine learning models reveal two distinct post-operative physical activity profiles among joint arthroplasty patients: a United Kingdom biobank cohort study. Arthroplasty. 2025. DOI: 10.1186/s42836-025-00339-6

[16] Effectiveness of Exercise Prehabilitation Before Anterior Cruciate Ligament Reconstruction on Functional Outcomes – A Single-Blinded Randomized Controlled Trial: Prevention, Prehab and Rehab. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/2325967126s00041

[17] Combined mode-kinetic chain exercise with and without core stability exercises on patients with knee osteoarthritis. BMC Musculoskeletal Disorders. 2026. DOI: 10.1186/s12891-026-09531-4

[18] Progressive tendon-loading eccentric exercise therapy in athletes with patellar tendinopathy improves postural control, quadriceps strength, and pain: A randomized clinical trial. Journal of ISAKOS. 2026. DOI: 10.1016/j.jisako.2026.101105

[19] Effects of home exercise-based mobile games on thumb rehabilitation outcomes. Hand Therapy. 2025. DOI: 10.1177/17589983251387079

[20] Effect of postoperative ankle pump exercises on the prevention of deep vein thrombosis and venous hemodynamics following lower limb orthopedic surgery: a meta-analysis of randomized controlled trials. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06236-7

[21] Comparative efficacy of mind–body exercise for pain, function, quality of life in knee osteoarthritis: a systematic review and network meta-analysis. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-05682-7