运动与步行方案对老年膝骨关节炎患者生活质量的影响。

Impact of an exercise and walking protocol on quality of life for elderly people with OA of the knee.

作者信息

Dias Rosângela Corrêa, Dias João Marcos Domingues, Ramos Luiz Roberto

机构信息

Physical Therapy Department, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.

出版信息

Physiother Res Int. 2003;8(3):121-30. doi: 10.1002/pri.280.

DOI:10.1002/pri.280

PMID:14533368

Abstract

BACKGROUND AND PURPOSE

The knee is the weight-bearing joint most commonly affected by osteoarthritis (OA). The symptoms of pain, morning stiffness of short duration and physical dysfunction in the activities of daily living (ADL) can have an effect on many aspects of health, affecting quality of life. Regular and moderate physical activity adapted to individuals' life-styles and education, and joint protection strategies have been advocated as conservative management. The purpose of the present study was to assess the impact of an exercise and walking protocol on the quality of life of elderly people with knee OA.

METHOD

The study design was a randomized controlled clinical trial. The subjects comprised 50 elderly people, aged 65 or more, with knee OA who had been referred to the geriatric outpatient unit for rehabilitation. Changes in severity of pain and quality of life were compared between a control group (CG) and an experimental group (EG). Both groups participated in an educational session and the EG also received a 12-week exercise and walking protocol. Both groups were assessed at baseline and after three and six months by an independent observer. The Lequesne Index of Knee OA Severity (LI), the Health Assessment Questionnaire (HAQ) and the Medical Outcomes Short-Form Health Survey (SF-36) were used as measurement instruments.

RESULTS

In the CG, the measures of quality of life (SF-36), the HAQ and the LI between subjects did not yield statistically significant differences over the three measurement points. For the EG, there was a significant improvement in function, measured by HAQ, and decreasing OA symptom severity, measured by LI. For the SF-36 there were significant improvements in physical function, functional role limitation and pain. Comparisons between the groups showed statistically significant differences after three and six months for all measures, except for the SF-36 emotional domains.

CONCLUSION

The exercise protocol and walking programme had a positive effect on the quality of life of elderly individuals with knee OA.

摘要

背景与目的

膝关节是骨关节炎（OA）最常累及的负重关节。疼痛、短期晨僵以及日常生活活动（ADL）中的身体功能障碍等症状会对健康的多个方面产生影响，进而影响生活质量。适应个体生活方式和受教育程度的规律适度体育活动以及关节保护策略已被倡导作为保守治疗方法。本研究的目的是评估运动和步行方案对老年膝骨关节炎患者生活质量的影响。

方法

本研究设计为随机对照临床试验。研究对象包括50名65岁及以上的老年膝骨关节炎患者，他们被转诊至老年门诊进行康复治疗。比较了对照组（CG）和实验组（EG）之间疼痛严重程度和生活质量的变化。两组均参加了一次教育课程，实验组还接受了为期12周的运动和步行方案。两组在基线时以及三个月和六个月后由独立观察者进行评估。采用膝关节骨关节炎严重程度Lequesne指数（LI）、健康评估问卷（HAQ）和医学结局简表健康调查（SF-36）作为测量工具。

结果

在对照组中，生活质量测量指标（SF-36）、HAQ和LI在三个测量点之间在受试者中未产生统计学显著差异。对于实验组，通过HAQ测量的功能有显著改善，通过LI测量的OA症状严重程度降低。对于SF-36，身体功能、功能角色限制和疼痛方面有显著改善。组间比较显示，除SF-36情感领域外，所有测量指标在三个月和六个月后均有统计学显著差异。