Mangione K K, McCully K, Gloviak A, Lefebvre I, Hofmann M, Craik R
Department of Physical Therapy, Beaver College, Glenside, Pennsylvania 19038, USA.
J Gerontol A Biol Sci Med Sci. 1999 Apr;54(4):M184-90. doi: 10.1093/gerona/54.4.m184.
People with osteoarthritis (OA) of the knee experience pain and deconditioning that lead to disability. This study challenged the clinical belief that repetitive lower extremity exercise is not indicated in persons with knee OA. The effects of high-intensity and low-intensity stationary cycling on functional status, gait, overall and acute pain, and aerobic capacity were examined.
Thirty-nine adults (71+/-6.9 years old) with complaints of knee pain and diagnosis of OA were randomized to either a high-intensity (70% heart rate reserve [HRR]) or low-intensity (40% HRR) exercise group for 10 weeks of stationary cycling. Participants cycled for 25 minutes, 3 times per week. Before and after the exercise intervention they completed the Arthritis Impact Measurement Scale 2 for overall pain assessment, underwent timed chair rise, 6-minute walk test, gait, and graded exercise treadmill tests. Acute pain was reported daily with a visual analog scale and the Western Ontario and McMaster Universities Osteoarthritis Index scale.
Analysis of variance revealed that participants in both groups significantly improved in the timed chair rise, in the 6-minute walk test, in the range of walking speeds, in the amount of overall pain relief, and in aerobic capacity. No differences between groups were found. Daily pain reports suggested that cycling did not increase acute pain in either group.
Cycling may be considered as an alternative exercise modality for patients with knee OA. Low-intensity cycling was as effective as high-intensity cycling in improving function and gait, decreasing pain, and increasing aerobic capacity.
膝骨关节炎（OA）患者会经历疼痛和身体机能下降，进而导致残疾。本研究对“膝OA患者不适合进行重复性下肢运动”这一临床观点提出了挑战。研究考察了高强度和低强度固定自行车运动对功能状态、步态、总体疼痛和急性疼痛以及有氧运动能力的影响。
39名主诉膝关节疼痛且被诊断为OA的成年人（71±6.9岁）被随机分为高强度（心率储备[HRR]的70%）或低强度（HRR的40%）运动组，进行为期10周的固定自行车运动。参与者每周骑行3次，每次25分钟。在运动干预前后，他们完成了关节炎影响测量量表2以进行总体疼痛评估，接受了定时起坐测试、6分钟步行测试、步态测试和分级运动平板测试。每天用视觉模拟量表以及西安大略和麦克马斯特大学骨关节炎指数量表报告急性疼痛情况。
方差分析显示，两组参与者在定时起坐测试、6分钟步行测试、步行速度范围、总体疼痛缓解程度和有氧运动能力方面均有显著改善。两组之间未发现差异。每日疼痛报告表明，骑行在两组中均未增加急性疼痛。
对于膝OA患者，骑行可被视为一种替代运动方式。低强度骑行在改善功能和步态、减轻疼痛以及提高有氧运动能力方面与高强度骑行同样有效。
