<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">smjournal</journal-id><journal-title-group><journal-title xml:lang="ru">Спортивная медицина: наука и практика</journal-title><trans-title-group xml:lang="en"><trans-title>Sports medicine: research and practice</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2223-2524</issn><issn pub-type="epub">2587-9014</issn><publisher><publisher-name>NEICON</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.17238/ISSN2223-2524.2018.4.71</article-id><article-id custom-type="elpub" pub-id-type="custom">smjournal-141</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>РЕАБИЛИТАЦИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REHABILITATION</subject></subj-group></article-categories><title-group><article-title>Роль снижения массы тела и физических упражнений в лечении гонартроза</article-title><trans-title-group xml:lang="en"><trans-title>Role of body mass reduction and physical exercises in treatment of gonarthrosis</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шкребко</surname><given-names>А. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Shkrebko</surname><given-names>A. N.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Глушаков</surname><given-names>А. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Glushakov</surname><given-names>A. N.</given-names></name></name-alternatives><email xlink:type="simple">sparta.kostroma@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff xml:lang="ru" id="aff-1"><institution>ФГБОУ ВО ЯГМУ Минздрава России</institution><country>Russian Federation</country></aff><pub-date pub-type="collection"><year>2018</year></pub-date><pub-date pub-type="epub"><day>21</day><month>08</month><year>2020</year></pub-date><volume>8</volume><issue>4</issue><fpage>71</fpage><lpage>79</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Шкребко А.Н., Глушаков А.Н., 2020</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="ru">Шкребко А.Н., Глушаков А.Н.</copyright-holder><copyright-holder xml:lang="en">Shkrebko A.N., Glushakov A.N.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.smjournal.ru/jour/article/view/141">https://www.smjournal.ru/jour/article/view/141</self-uri><abstract><p>Выполнен анализ литературных данных о современных методах лечения гонартроза, основанных на снижении массы тела больных. Рассмотрена патогенетическая взаимосвязь ожирения и остеоартроза, в частности, роль адипокинов, приведены сведения о том, что снижение массы тела способствует положительной динамике функционального состояния суставов, пораженных остеоартрозом. При этом отмечается наличие сложной системы физических, личностных, психологических и социальных барьеров и стимулов в поддержании этими больными должного уровня физической активности. Указано, что одним из направлений повышения эффективности лечения должно стать применение методов, позволяющих активизировать пациента с остеоартрозом. Отмечена необходимость разработки и апробации методов, в основе которых должны лежать программы по повышению уровня физической активности больных, в том числе применение методов лечебной физической культуры.</p></abstract><trans-abstract xml:lang="en"><p>The analysis of literature data on modern methods of gonarthrosis treatment based on a decrease in the body weight of patients was conducted. The pathogenetic relationship between obesity and osteoarthritis, in particular, the role of adipokines, was considered. It was shown that a decrease in body weight contributed to a positive dynamics of the functional state of joints affected by osteoarthritis. At the same time, there was a complex system of physical, personal, psychological and social barriers and incentives to keep these patients at the proper level of physical activity. It was indicated that one of the ways to improve the effectiveness of treatment should be the use of methods that activate patients with osteoarthritis. The need to develop and approbate methods based on programs to increase the level of physical activity of patients, including the use of methods of therapeutic physical training was noted.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>остеоартроз</kwd><kwd>гонартроз</kwd><kwd>лечебная физкультура</kwd><kwd>тучность</kwd><kwd>адипокины</kwd></kwd-group><kwd-group xml:lang="en"><kwd>osteoarthritis</kwd><kwd>gonarthrosis</kwd><kwd>therapeutic exercise</kwd><kwd>obesity</kwd><kwd>adipokines</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Лапшина С.А., Мухина Р.Г., Мясоутова Л.И. Остеоартроз: современные проблемы терапии // РМЖ. 2016. Т.24, № 2. С. 95-101.</mixed-citation><mixed-citation xml:lang="en">Лапшина С.А., Мухина Р.Г., Мясоутова Л.И. Остеоартроз: современные проблемы терапии // РМЖ. 2016. Т.24, № 2. С. 95-101.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Шостак H.A., Правдюк Н.Г. Остеоартроз: детерминанты боли, подходы к лечению // РМЖ. 2016. Т.24, № 22. С. 1476-80.</mixed-citation><mixed-citation xml:lang="en">Шостак H.A., Правдюк Н.Г. Остеоартроз: детерминанты боли, подходы к лечению // РМЖ. 2016. Т.24, № 22. С. 1476-80.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">NICE. Osteoarthritis care and management in adults. NICE clinical guideline. 2014. 177 p. PMID: 25340227.</mixed-citation><mixed-citation xml:lang="en">NICE. Osteoarthritis care and management in adults. NICE clinical guideline. 2014. 177 p. PMID: 25340227.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Вакуленко О.Ю., Жиляев Е.В. Остеоартроз: современные подходы к лечению // РМЖ. 2016. Т.24, № 22. С. 1494-8.</mixed-citation><mixed-citation xml:lang="en">Вакуленко О.Ю., Жиляев Е.В. Остеоартроз: современные подходы к лечению // РМЖ. 2016. Т.24, № 22. С. 1494-8.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Jiang L., Tian W., Wang Y., Rong J., Bao C., Liu Y., Zhao Y., Wang C., Jiang L., Tian W., Wang Y. et al. Body mass index and susceptibility to knee osteoarthritis: a systematic review and metaanalysis // Joint Bone Spine. 2012. Vol. 79, № 3. P. 291-7. DOI: 10.1016/j.jbspin.2011.05.015.</mixed-citation><mixed-citation xml:lang="en">Jiang L., Tian W., Wang Y., Rong J., Bao C., Liu Y., Zhao Y., Wang C., Jiang L., Tian W., Wang Y. et al. Body mass index and susceptibility to knee osteoarthritis: a systematic review and metaanalysis // Joint Bone Spine. 2012. Vol. 79, № 3. P. 291-7. DOI: 10.1016/j.jbspin.2011.05.015.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Davis M.A., Ettinger W.H., Neuhaus J.M. Obesity and osteoarthritis of the knee: evidence from the National Health and Nutrition Examination Survey (NHANES I) // Semin Arthritis Rheum. 1990. Vol. 20, № 3. P. 34-41. DOI: 10.1016/0049-0172(90)90045-H.</mixed-citation><mixed-citation xml:lang="en">Davis M.A., Ettinger W.H., Neuhaus J.M. Obesity and osteoarthritis of the knee: evidence from the National Health and Nutrition Examination Survey (NHANES I) // Semin Arthritis Rheum. 1990. Vol. 20, № 3. P. 34-41. DOI: 10.1016/0049-0172(90)90045-H.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Гайфутдинов И.М. Лечебная физическая культура (ЛФК) при артрозе // Сборник материалов XXXIX Международной научно-практической конференции «Приоритетные научные направления: от теории к практике». М., 2017. С. 29-32.</mixed-citation><mixed-citation xml:lang="en">Гайфутдинов И.М. Лечебная физическая культура (ЛФК) при артрозе // Сборник материалов XXXIX Международной научно-практической конференции «Приоритетные научные направления: от теории к практике». М., 2017. С. 29-32.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Anwer S., Alghadir A., Brismée J.M. Effect of home exercise program in patients with knee osteoarthritis: a systematic review and meta-analysis // J. Geriatr Phys Ther. 2016. Vol. 39. P. 38-48. DOI: 10.1519/JPT.0000000000000045.</mixed-citation><mixed-citation xml:lang="en">Anwer S., Alghadir A., Brismée J.M. Effect of home exercise program in patients with knee osteoarthritis: a systematic review and meta-analysis // J. Geriatr Phys Ther. 2016. Vol. 39. P. 38-48. DOI: 10.1519/JPT.0000000000000045.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Duivenvoorden T., Brouwer R.W., Van Raaij T.M. Braces and orthoses for treating osteoarthritis of the knee // Cochrane Database Syst. Rev. 2005. DOI: 10.1002/14651858.CD004020.pub2.</mixed-citation><mixed-citation xml:lang="en">Duivenvoorden T., Brouwer R.W., Van Raaij T.M. Braces and orthoses for treating osteoarthritis of the knee // Cochrane Database Syst. Rev. 2005. DOI: 10.1002/14651858.CD004020.pub2.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Parkes M.J., Maricar N., Lunt M., LaValley M.P., Jones R.K., Segal N. A., Takahashi-Narita K., Felson D.T. Lateral wedge insoles as a conservative treatment for pain in patients with medial knee osteoarthritis: a meta-analysis // JAMA. 2013. Vol. 310. P. 722-30. DOI: 10.1001/jama.2013.243229.</mixed-citation><mixed-citation xml:lang="en">Parkes M.J., Maricar N., Lunt M., LaValley M.P., Jones R.K., Segal N. A., Takahashi-Narita K., Felson D.T. Lateral wedge insoles as a conservative treatment for pain in patients with medial knee osteoarthritis: a meta-analysis // JAMA. 2013. Vol. 310. P. 722-30. DOI: 10.1001/jama.2013.243229.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Crossley K.M., Marino G.P., Madlquham M.D., Schache A.G., Hinman R.S. Can patellar tape reduce the patellar malalignment and pain associated with patellofemoral osteoar-thritis? // Arthritis Rheum. 2009. Vol. 61. P. 1719-25. DOI: 10.1002/art.24872.</mixed-citation><mixed-citation xml:lang="en">Crossley K.M., Marino G.P., Madlquham M.D., Schache A.G., Hinman R.S. Can patellar tape reduce the patellar malalignment and pain associated with patellofemoral osteoar-thritis? // Arthritis Rheum. 2009. Vol. 61. P. 1719-25. DOI: 10.1002/art.24872.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Warden S.J., Hinman R.S., Watson M.A. Jr., Avin K.G., Bialocerkowski A.E., Crossley K.M. Patellar taping and bracing for the treatment of chronic knee pain: a systematic review and metaanalysis // Arthritis Rheum. 2008. Vol. 59. P. 73-83. DOI: 10.1002/ art.23242.</mixed-citation><mixed-citation xml:lang="en">Warden S.J., Hinman R.S., Watson M.A. Jr., Avin K.G., Bialocerkowski A.E., Crossley K.M. Patellar taping and bracing for the treatment of chronic knee pain: a systematic review and metaanalysis // Arthritis Rheum. 2008. Vol. 59. P. 73-83. DOI: 10.1002/ art.23242.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Handbook of Non-Drug Intervention (HANDI) Project Team. Taping for knee osteoarthritis // Aust. Fam. Physician. 2013. Vol. 42. P. 725-6. DOI: 10.1016/j.ctcp.2015.10.001.</mixed-citation><mixed-citation xml:lang="en">Handbook of Non-Drug Intervention (HANDI) Project Team. Taping for knee osteoarthritis // Aust. Fam. Physician. 2013. Vol. 42. P. 725-6. DOI: 10.1016/j.ctcp.2015.10.001.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Jones A., Silva P.G., Silva A.C., Colucci M., Tuffanin A., Jardim J.R., Natour J. Impact of cane use on pain, function, general health and energy expenditure during gait in patients with knee osteoarthritis: a randomised controlled trial // Ann. Rheum. Dis. 2012. Vol. 71. P. 172-9. DOI: 10.1136/ard.2010.140178.</mixed-citation><mixed-citation xml:lang="en">Jones A., Silva P.G., Silva A.C., Colucci M., Tuffanin A., Jardim J.R., Natour J. Impact of cane use on pain, function, general health and energy expenditure during gait in patients with knee osteoarthritis: a randomised controlled trial // Ann. Rheum. Dis. 2012. Vol. 71. P. 172-9. DOI: 10.1136/ard.2010.140178.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Lin X., Huang K., Zhu G., Huang Z., Qin A., Fan S. The effects of acupuncture on chronic knee pain due to osteoarthritis: a meta-analysis // J. Bone Joint Surg. Am. 2016. Vol. 98. P. 1578-85. DOI: 10.2106/JBJS.15.00620.</mixed-citation><mixed-citation xml:lang="en">Lin X., Huang K., Zhu G., Huang Z., Qin A., Fan S. The effects of acupuncture on chronic knee pain due to osteoarthritis: a meta-analysis // J. Bone Joint Surg. Am. 2016. Vol. 98. P. 1578-85. DOI: 10.2106/JBJS.15.00620.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Cherian J.J., Harrison P.E., Benjamin S.A., Bhave A., Harwin S.F., Mont M.A. Do the effects of transcutaneous electrical nerve stimulation on knee osteoarthritis pain and function last? // J. Knee Surg. 2016. Vol. 29. P. 497-501. DOI: 10.1055/s-0035-1566735.</mixed-citation><mixed-citation xml:lang="en">Cherian J.J., Harrison P.E., Benjamin S.A., Bhave A., Harwin S.F., Mont M.A. Do the effects of transcutaneous electrical nerve stimulation on knee osteoarthritis pain and function last? // J. Knee Surg. 2016. Vol. 29. P. 497-501. DOI: 10.1055/s-0035-1566735.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Chen L.X., Zhou Z.R. Transcutaneous electrical nerve stimulation in patients with knee osteoarthritis: evidence from randomized-controlled trials // Clin. J. Pain. 2016. Vol. 32. P. 146-54. DOI: 10.1097/AJP.0000000000000233.</mixed-citation><mixed-citation xml:lang="en">Chen L.X., Zhou Z.R. Transcutaneous electrical nerve stimulation in patients with knee osteoarthritis: evidence from randomized-controlled trials // Clin. J. Pain. 2016. Vol. 32. P. 146-54. DOI: 10.1097/AJP.0000000000000233.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Sharma L., Cahue S., Song J., Hayes K., Pai Y.C., Dunlop D. Physical functioning over three years in knee osteoarthritis: role of psychosocial, local mechanical, and neuromuscular factors // Arthritis Rheum. 2003. Vol. 48. P. 3359-70. DOI: 10.1002/art.11420.</mixed-citation><mixed-citation xml:lang="en">Sharma L., Cahue S., Song J., Hayes K., Pai Y.C., Dunlop D. Physical functioning over three years in knee osteoarthritis: role of psychosocial, local mechanical, and neuromuscular factors // Arthritis Rheum. 2003. Vol. 48. P. 3359-70. DOI: 10.1002/art.11420.</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">De Boer T.N., Van Spil W.E., Huisman A.M., Polak A.A., Bijlsma J.W., Lafeber F.P., Mastbergen S.C. Serum adipokines in osteoarthritis; comparison with controls and relationship with local parameters of synovial inflammation and cartilage damage // Osteoarthr. Cartilage. 2012. Vol. 20, № 8. P.846-53. DOI: 10.1016/j.joca.2012.05.002.</mixed-citation><mixed-citation xml:lang="en">De Boer T.N., Van Spil W.E., Huisman A.M., Polak A.A., Bijlsma J.W., Lafeber F.P., Mastbergen S.C. Serum adipokines in osteoarthritis; comparison with controls and relationship with local parameters of synovial inflammation and cartilage damage // Osteoarthr. Cartilage. 2012. Vol. 20, № 8. P.846-53. DOI: 10.1016/j.joca.2012.05.002.</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Brennan S.L., Cicuttini F.M., Pasco J.A., Henry M.J., Wang Y., Kotowicz M.A., Nicholson G.C., Wluka A.E. Does an increase in body mass index over 10 years affect knee structure in a population-based cohort study of adult women? // Arthritis Res. Ther. 2010. Vol. 12, № 4. P. 139. DOI: 10.1186/ar3078.</mixed-citation><mixed-citation xml:lang="en">Brennan S.L., Cicuttini F.M., Pasco J.A., Henry M.J., Wang Y., Kotowicz M.A., Nicholson G.C., Wluka A.E. Does an increase in body mass index over 10 years affect knee structure in a population-based cohort study of adult women? // Arthritis Res. Ther. 2010. Vol. 12, № 4. P. 139. DOI: 10.1186/ar3078.</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Laberge M.A., Baum T., Virayavanich W., Nardo L., Nevitt M.C., Lynch J., McCulloch C.E., Link T.M. Obesity increases the prevalence and severity of focal knee abnormalities diagnosed using 3T MRI in middle-aged subjects - data from the Osteoarthritis Initiative // Skeletal Radiol. 2012. Vol. 41, № 6. R 633-41. DOI: 10.1007/s00256-011-1259-3.</mixed-citation><mixed-citation xml:lang="en">Laberge M.A., Baum T., Virayavanich W., Nardo L., Nevitt M.C., Lynch J., McCulloch C.E., Link T.M. Obesity increases the prevalence and severity of focal knee abnormalities diagnosed using 3T MRI in middle-aged subjects - data from the Osteoarthritis Initiative // Skeletal Radiol. 2012. Vol. 41, № 6. R 633-41. DOI: 10.1007/s00256-011-1259-3.</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">Fantuzzi G., Mazzone T.Nutrition and Health: Adipose Tissue and Adipokines. Health and Disease. New York: SpringerVerlag, 2007. 279 p.</mixed-citation><mixed-citation xml:lang="en">Fantuzzi G., Mazzone T.Nutrition and Health: Adipose Tissue and Adipokines. Health and Disease. New York: SpringerVerlag, 2007. 279 p.</mixed-citation></citation-alternatives></ref><ref id="cit23"><label>23</label><citation-alternatives><mixed-citation xml:lang="ru">McNulty A.L., Miller M.R., O'Connor S.K., Guilak F. The effects of adipokines on cartilage and meniscus catabolism // Connect Tissue Res. 2011. Vol. 52, № 6. P. 523-33. DOI: 10.3109/03008207.2011.597902.</mixed-citation><mixed-citation xml:lang="en">McNulty A.L., Miller M.R., O'Connor S.K., Guilak F. The effects of adipokines on cartilage and meniscus catabolism // Connect Tissue Res. 2011. Vol. 52, № 6. P. 523-33. DOI: 10.3109/03008207.2011.597902.</mixed-citation></citation-alternatives></ref><ref id="cit24"><label>24</label><citation-alternatives><mixed-citation xml:lang="ru">Santos M.J., Fonseca J.E. Metabolic syndrome, Inflammation and atherosclerosis - the role of adipokinesin health and in systemic inflammatory rheumatic diseaseas // Acta Reumatol. Port. 2009. Vol. 34, № 4. P. 590-8. PMID: 20852572.</mixed-citation><mixed-citation xml:lang="en">Santos M.J., Fonseca J.E. Metabolic syndrome, Inflammation and atherosclerosis - the role of adipokinesin health and in systemic inflammatory rheumatic diseaseas // Acta Reumatol. Port. 2009. Vol. 34, № 4. P. 590-8. PMID: 20852572.</mixed-citation></citation-alternatives></ref><ref id="cit25"><label>25</label><citation-alternatives><mixed-citation xml:lang="ru">Gualillo O., Gonzalez-Juanatey J.R., Lago F. The emerging role of adipokines as mediators of cardiovascular function: physiologic and clinical perspectives // Trends Cardiovasc. Med. 2007. Vol. 17, № 8. P. 275-83. DOI: 10,1016/j.tcm.2007.09.005.</mixed-citation><mixed-citation xml:lang="en">Gualillo O., Gonzalez-Juanatey J.R., Lago F. The emerging role of adipokines as mediators of cardiovascular function: physiologic and clinical perspectives // Trends Cardiovasc. Med. 2007. Vol. 17, № 8. P. 275-83. DOI: 10,1016/j.tcm.2007.09.005.</mixed-citation></citation-alternatives></ref><ref id="cit26"><label>26</label><citation-alternatives><mixed-citation xml:lang="ru">McAlindon T.E., Bannuru R.R., Sullivan M.C., Arden N.K., Berenbaum F., Bierma-Zeinstra S.M., Hawker G.A., Henrotin Y., Hunter D.J., Kawaguchi H., Kwoh K., Lohmander S., Rannou F., Roos E.M., Underwood M. OARSI guidelines for the non-surgical management of knee osteoarthritis // Osteoarthritis Cartilage. 2014. Vol. 22. P. 363-88. DOI: 10.1016/j.joca.2014.01.003.</mixed-citation><mixed-citation xml:lang="en">McAlindon T.E., Bannuru R.R., Sullivan M.C., Arden N.K., Berenbaum F., Bierma-Zeinstra S.M., Hawker G.A., Henrotin Y., Hunter D.J., Kawaguchi H., Kwoh K., Lohmander S., Rannou F., Roos E.M., Underwood M. OARSI guidelines for the non-surgical management of knee osteoarthritis // Osteoarthritis Cartilage. 2014. Vol. 22. P. 363-88. DOI: 10.1016/j.joca.2014.01.003.</mixed-citation></citation-alternatives></ref><ref id="cit27"><label>27</label><citation-alternatives><mixed-citation xml:lang="ru">Caspersen C.J., Powell K.E., Christenson G.M. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research // Public Health Rep. 1985. Vol. 100. P. 126-31. PMC1424733.</mixed-citation><mixed-citation xml:lang="en">Caspersen C.J., Powell K.E., Christenson G.M. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research // Public Health Rep. 1985. Vol. 100. P. 126-31. PMC1424733.</mixed-citation></citation-alternatives></ref><ref id="cit28"><label>28</label><citation-alternatives><mixed-citation xml:lang="ru">Juhl C., Christensen R., Roos E.M. et al. Impact of exercise type and dose on pain and disability in knee osteoarthritis: a systematic review and meta-regression analysis of randomized controlled trials // Arthritis Rheumatol. 2014. Vol. 66. P. 622-36. DOI: 10.1002/art.38290.</mixed-citation><mixed-citation xml:lang="en">Juhl C., Christensen R., Roos E.M. et al. Impact of exercise type and dose on pain and disability in knee osteoarthritis: a systematic review and meta-regression analysis of randomized controlled trials // Arthritis Rheumatol. 2014. Vol. 66. P. 622-36. DOI: 10.1002/art.38290.</mixed-citation></citation-alternatives></ref><ref id="cit29"><label>29</label><citation-alternatives><mixed-citation xml:lang="ru">Christensen R., Bartels E.M., Astrup A., Bliddal H. Effect of weight reduction in obese patients diagnosed with knee osteoarthritis: a systematic review and meta-analysis // Ann. Rheum. Dis. 2007. Vol. 66. P. 433-9. DOI: 10.1136/ard.2006.065904.</mixed-citation><mixed-citation xml:lang="en">Christensen R., Bartels E.M., Astrup A., Bliddal H. Effect of weight reduction in obese patients diagnosed with knee osteoarthritis: a systematic review and meta-analysis // Ann. Rheum. Dis. 2007. Vol. 66. P. 433-9. DOI: 10.1136/ard.2006.065904.</mixed-citation></citation-alternatives></ref><ref id="cit30"><label>30</label><citation-alternatives><mixed-citation xml:lang="ru">Messier S.P., Mihalko S.L., Legault C., Miller G.D., Nick-las B.J., DeVita P., Beavers D.P., Hunter D.J., Lyles M.F., Eckstein F., Williamson J.D., Carr J.J., Guermazi A., Loeser R.F. Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial // JAMA. 2013. Vol. 310, № 12. P. 1263-73. DOI: 10.1001/jama.2013.277669.</mixed-citation><mixed-citation xml:lang="en">Messier S.P., Mihalko S.L., Legault C., Miller G.D., Nick-las B.J., DeVita P., Beavers D.P., Hunter D.J., Lyles M.F., Eckstein F., Williamson J.D., Carr J.J., Guermazi A., Loeser R.F. Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial // JAMA. 2013. Vol. 310, № 12. P. 1263-73. DOI: 10.1001/jama.2013.277669.</mixed-citation></citation-alternatives></ref><ref id="cit31"><label>31</label><citation-alternatives><mixed-citation xml:lang="ru">Fransen M., McConnell S., Harmer A.R., Van der Esch M., Simic M., Bennell K.L. Exercise for osteoarthritis of the knee: a Cochrane systematic review // Br. J. Sports Med. 2015. Vol. 49. P. 1554-7. DOI: 10.1136/bjsports-2015-095424.</mixed-citation><mixed-citation xml:lang="en">Fransen M., McConnell S., Harmer A.R., Van der Esch M., Simic M., Bennell K.L. Exercise for osteoarthritis of the knee: a Cochrane systematic review // Br. J. Sports Med. 2015. Vol. 49. P. 1554-7. DOI: 10.1136/bjsports-2015-095424.</mixed-citation></citation-alternatives></ref><ref id="cit32"><label>32</label><citation-alternatives><mixed-citation xml:lang="ru">Hochberg M.C., Altman R.D., April K.T., Benklialti M., Guyatt G., McGowan J., Towheed T., Welch V., Wells G., Tugwell P. American College of Rheumatology. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee // Arthritis Care Res (Hoboken). 2012. Vol. 64. P. 465-74. DOI: 10.1002/acr.21596.</mixed-citation><mixed-citation xml:lang="en">Hochberg M.C., Altman R.D., April K.T., Benklialti M., Guyatt G., McGowan J., Towheed T., Welch V., Wells G., Tugwell P. American College of Rheumatology. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee // Arthritis Care Res (Hoboken). 2012. Vol. 64. P. 465-74. DOI: 10.1002/acr.21596.</mixed-citation></citation-alternatives></ref><ref id="cit33"><label>33</label><citation-alternatives><mixed-citation xml:lang="ru">Batsis J.A., Germain C.M., Vâsquez E., Zbehlik A.J., Bartels S.J. Physical activity predicts higher physical function in older adults: the osteoarthritis initiative // J. Phys. Act. Health. 2016. Vol. 13. P. 6-16. DOI: 10.1123/jpah.2014-0531.</mixed-citation><mixed-citation xml:lang="en">Batsis J.A., Germain C.M., Vâsquez E., Zbehlik A.J., Bartels S.J. Physical activity predicts higher physical function in older adults: the osteoarthritis initiative // J. Phys. Act. Health. 2016. Vol. 13. P. 6-16. DOI: 10.1123/jpah.2014-0531.</mixed-citation></citation-alternatives></ref><ref id="cit34"><label>34</label><citation-alternatives><mixed-citation xml:lang="ru">Chmelo E., Nicklas B., Davis C., Miller G.D., Legault C., Messier S. Physical activity and physical function in older adults with knee osteoarthritis // J. Phys Act Health. 2013. Vol. 10. P. 777-83. DOI: 10.1123/jpah.10.6.777.</mixed-citation><mixed-citation xml:lang="en">Chmelo E., Nicklas B., Davis C., Miller G.D., Legault C., Messier S. Physical activity and physical function in older adults with knee osteoarthritis // J. Phys Act Health. 2013. Vol. 10. P. 777-83. DOI: 10.1123/jpah.10.6.777.</mixed-citation></citation-alternatives></ref><ref id="cit35"><label>35</label><citation-alternatives><mixed-citation xml:lang="ru">Lin W., Alizai H., Joseph G.B., Srikhum W., Nevitt M.C., Lynch J.A., McCulloch C.E., Link T.M. Physical activity in relation to knee cartilage T2 progression measured with 3 T MRI over a period of 4 years: data from the Osteoarthritis Initiative // Osteoarthritis Cartilage. 2013. Vol. 21. P. 1558-66. DOI: 10.1016/j.joca.2013.06.022.</mixed-citation><mixed-citation xml:lang="en">Lin W., Alizai H., Joseph G.B., Srikhum W., Nevitt M.C., Lynch J.A., McCulloch C.E., Link T.M. Physical activity in relation to knee cartilage T2 progression measured with 3 T MRI over a period of 4 years: data from the Osteoarthritis Initiative // Osteoarthritis Cartilage. 2013. Vol. 21. P. 1558-66. DOI: 10.1016/j.joca.2013.06.022.</mixed-citation></citation-alternatives></ref><ref id="cit36"><label>36</label><citation-alternatives><mixed-citation xml:lang="ru">Loprinzi P.D., Sheffield J., Tyo B.M., Fittipaldi-Wert J. Accelerometer-determined physical activity, mobility disability, and health // Disabil. Health J. 2014. Vol. 7. P. 419-25. DOI: 10.1016/j.dhjo.2014.05.005.</mixed-citation><mixed-citation xml:lang="en">Loprinzi P.D., Sheffield J., Tyo B.M., Fittipaldi-Wert J. Accelerometer-determined physical activity, mobility disability, and health // Disabil. Health J. 2014. Vol. 7. P. 419-25. DOI: 10.1016/j.dhjo.2014.05.005.</mixed-citation></citation-alternatives></ref><ref id="cit37"><label>37</label><citation-alternatives><mixed-citation xml:lang="ru">Zhang W., Nuki G., Moskowitz R.W., Abramson S., Altman R.D., Arden N.K., Bierma-Zeinstra S., Brandt K.D., Croft P., Doherty M., Dougados M., Hochberg M., Hunter D.J., Kwoh K., Lohmander L.S., Tugwell P. OARSI recommendations for the management of hip and knee osteoarthritis: part III: Changes in evidence following systematic cumulative update of research published through January 2009 // Osteoarthritis Cartilage. 2010. Vol. 18, № 4. P. 476-99. DOI: 10.1016/j.joca.2010.01.013.</mixed-citation><mixed-citation xml:lang="en">Zhang W., Nuki G., Moskowitz R.W., Abramson S., Altman R.D., Arden N.K., Bierma-Zeinstra S., Brandt K.D., Croft P., Doherty M., Dougados M., Hochberg M., Hunter D.J., Kwoh K., Lohmander L.S., Tugwell P. OARSI recommendations for the management of hip and knee osteoarthritis: part III: Changes in evidence following systematic cumulative update of research published through January 2009 // Osteoarthritis Cartilage. 2010. Vol. 18, № 4. P. 476-99. DOI: 10.1016/j.joca.2010.01.013.</mixed-citation></citation-alternatives></ref><ref id="cit38"><label>38</label><citation-alternatives><mixed-citation xml:lang="ru">Richette P., Poitou C., Garnero P., Vicaut E., Bouillot J.L., Lacorte J.M., Basdevant A., Clément K., Bardin T., Chevalier X. Benefits ofmassiveweightloss on symptoms, systemic inflammation and cartilage turnover in obese patients with knee osteoarthritis // Ann. Rheum. Dis. 2011. Vol. 70, № 1. P. 139-44. DOI: 10.1136/ard.2010.134015.</mixed-citation><mixed-citation xml:lang="en">Richette P., Poitou C., Garnero P., Vicaut E., Bouillot J.L., Lacorte J.M., Basdevant A., Clément K., Bardin T., Chevalier X. Benefits ofmassiveweightloss on symptoms, systemic inflammation and cartilage turnover in obese patients with knee osteoarthritis // Ann. Rheum. Dis. 2011. Vol. 70, № 1. P. 139-44. DOI: 10.1136/ard.2010.134015.</mixed-citation></citation-alternatives></ref><ref id="cit39"><label>39</label><citation-alternatives><mixed-citation xml:lang="ru">Colbert C.J., Almagor O., Chmiel J.S., Song J., Dunlop D., Hayes K.W., Sharma L. Excess body weight and four-year function outcomes: comparison of African Americans and whites in a prospective study of osteoarthritis // Arthritis Care Res (Hoboken). 2013. Vol. 65, № 1. P. 5-14. DOI: 10.1002/acr.21811.</mixed-citation><mixed-citation xml:lang="en">Colbert C.J., Almagor O., Chmiel J.S., Song J., Dunlop D., Hayes K.W., Sharma L. Excess body weight and four-year function outcomes: comparison of African Americans and whites in a prospective study of osteoarthritis // Arthritis Care Res (Hoboken). 2013. Vol. 65, № 1. P. 5-14. DOI: 10.1002/acr.21811.</mixed-citation></citation-alternatives></ref><ref id="cit40"><label>40</label><citation-alternatives><mixed-citation xml:lang="ru">Tanamas S.K., Wluka A.E. Association of weight gain with incident knee pain, stiffness, and functional difëculties: A longitudinal study // Arthritis Care Res. 2013. Vol. 65, № 1. P. 34-43. DOI: 10.1002/acr.21745.</mixed-citation><mixed-citation xml:lang="en">Tanamas S.K., Wluka A.E. Association of weight gain with incident knee pain, stiffness, and functional difëculties: A longitudinal study // Arthritis Care Res. 2013. Vol. 65, № 1. P. 34-43. DOI: 10.1002/acr.21745.</mixed-citation></citation-alternatives></ref><ref id="cit41"><label>41</label><citation-alternatives><mixed-citation xml:lang="ru">Messier S.P., Mihalko S.L., Legault C., Miller G.D., Nicklas B.J., DeVita P., Beavers D.P., Hunter D.J., Lyles M.F., Eckstein F., Williamson J.D., Carr J.J., Guermazi A., Loeser R.F. Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial // JAMA. 2013. Vol. 310. P. 1263-73. DOI: 10.1001/Jama.2013.277669.</mixed-citation><mixed-citation xml:lang="en">Messier S.P., Mihalko S.L., Legault C., Miller G.D., Nicklas B.J., DeVita P., Beavers D.P., Hunter D.J., Lyles M.F., Eckstein F., Williamson J.D., Carr J.J., Guermazi A., Loeser R.F. Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial // JAMA. 2013. Vol. 310. P. 1263-73. DOI: 10.1001/Jama.2013.277669.</mixed-citation></citation-alternatives></ref><ref id="cit42"><label>42</label><citation-alternatives><mixed-citation xml:lang="ru">Riddleand D.L., Stratford P.W. Body weight changes and corresponding changes in pain and function in persons with symptomatic knee osteoarthritis: A cohort study // Arthritis Care Res. 2013. Vol. 65, № 1. P. 15-22. DOI: 10.1002/acr.21692.</mixed-citation><mixed-citation xml:lang="en">Riddleand D.L., Stratford P.W. Body weight changes and corresponding changes in pain and function in persons with symptomatic knee osteoarthritis: A cohort study // Arthritis Care Res. 2013. Vol. 65, № 1. P. 15-22. DOI: 10.1002/acr.21692.</mixed-citation></citation-alternatives></ref><ref id="cit43"><label>43</label><citation-alternatives><mixed-citation xml:lang="ru">Rai M.F., Sandeil L.J. Inflammatory mediators: tracing links between obesity and osteoarthritis // Crit. Rev. Eukaryot Gene Expr. 2011. Vol. 21, № 2. P. 131-42. DOI: 10.1615/CritRevEukarGeneExpr.v21.i2.30.</mixed-citation><mixed-citation xml:lang="en">Rai M.F., Sandeil L.J. Inflammatory mediators: tracing links between obesity and osteoarthritis // Crit. Rev. Eukaryot Gene Expr. 2011. Vol. 21, № 2. P. 131-42. DOI: 10.1615/CritRevEukarGeneExpr.v21.i2.30.</mixed-citation></citation-alternatives></ref><ref id="cit44"><label>44</label><citation-alternatives><mixed-citation xml:lang="ru">Савельева Л.В. Современная концепция лечения ожирения: клинические рекомендации для практикующих врачей // Фарматека. 2007. № 12. С. 33-8.</mixed-citation><mixed-citation xml:lang="en">Савельева Л.В. Современная концепция лечения ожирения: клинические рекомендации для практикующих врачей // Фарматека. 2007. № 12. С. 33-8.</mixed-citation></citation-alternatives></ref><ref id="cit45"><label>45</label><citation-alternatives><mixed-citation xml:lang="ru">Finer N., James W.P., Kopelman P.G., Lean M.E., Williams G. One-year treatment of obesity: a randomized, double-blind, placebo-controlled, multicenter study of orlistat, a gastrointestinal lipase inhibitor // Int. J. Obesity. 2000. Vol. 24. P. 306-13. DOI: 10.1038/sj.ijo.0801128.</mixed-citation><mixed-citation xml:lang="en">Finer N., James W.P., Kopelman P.G., Lean M.E., Williams G. One-year treatment of obesity: a randomized, double-blind, placebo-controlled, multicenter study of orlistat, a gastrointestinal lipase inhibitor // Int. J. Obesity. 2000. Vol. 24. P. 306-13. DOI: 10.1038/sj.ijo.0801128.</mixed-citation></citation-alternatives></ref><ref id="cit46"><label>46</label><citation-alternatives><mixed-citation xml:lang="ru">Toplak H., Ziegler O., Keller U., Hamann A., Godin C., Wittert G., Zanella M.T., Züniga-Guajardo S., Van Gaal L. X-PERT: weight reduction with orlistat in obese subjects receiving a mildly or moderately reduced-energy diet. Early response to treatment predicts weight maintenance // Diabet. Obes. Metabol. 2005. Vol. 7. P. 699-708. DOI: 10.1111/j.l463-1326.2005.00483.x.</mixed-citation><mixed-citation xml:lang="en">Toplak H., Ziegler O., Keller U., Hamann A., Godin C., Wittert G., Zanella M.T., Züniga-Guajardo S., Van Gaal L. X-PERT: weight reduction with orlistat in obese subjects receiving a mildly or moderately reduced-energy diet. Early response to treatment predicts weight maintenance // Diabet. Obes. Metabol. 2005. Vol. 7. P. 699-708. DOI: 10.1111/j.l463-1326.2005.00483.x.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
