Moss Penny, Sluka Kathleen, Wright Anthony
School of Physiotherapy, Curtin University of Technology, GPO Box U1987, Perth, WA, Australia.
Man Ther. 2007 May;12(2):109-18. doi: 10.1016/j.math.2006.02.009. Epub 2006 Jun 13.
Physiotherapists often employ lower limb joint mobilization to reduce pain and increase function. However, there is little experimental data confirming its efficacy. The purpose of this study was to investigate the initial effects of accessory knee joint mobilization on measures of pain and function in individuals with knee osteoarthritis. The study employed a double-blind, controlled, within-subjects repeated-measures design. Thirty-eight subjects with mild to moderate knee pain participated. The effects of a 9-min, non-noxious, AP mobilization of the tibio-femoral joint were compared with manual contact and no-contact interventions. Pressure pain threshold (PPT) and 3-m 'up and go' time were measured immediately before and after each intervention. Results demonstrated a significantly greater mean (95% CI) percentage increase in PPT following knee joint mobilization (27.3% (20.9-33.7)) than after manual contact (6.4% (0.4-12.4)) or no-contact (-9.6% (-20.7 to 1.6)) interventions. Knee joint mobilization also increased PPT at a distal, non-painful site and reduced 'up and go' time significantly more (-5% (-9.3 to 0.8)) than manual contact (-0.4% (-4.2 to 3.5)) or no-contact control (+7.9% (2.6-13.2)) interventions. This study therefore provides new experimental evidence that accessory mobilization of an osteoarthritic knee joint immediately produces both local and widespread hypoalgesic effects. It may therefore be an effective means of reducing pain in this population.
物理治疗师经常采用下肢关节松动术来减轻疼痛并提高功能。然而，几乎没有实验数据证实其疗效。本研究的目的是调查膝关节附属松动术对膝骨关节炎患者疼痛和功能指标的初始影响。该研究采用了双盲、对照、受试者内重复测量设计。38名有轻度至中度膝关节疼痛的受试者参与了研究。将9分钟的非伤害性胫股关节前后向松动术的效果与手法接触和非接触干预进行了比较。在每次干预前后立即测量压力疼痛阈值（PPT）和3米“起身走”时间。结果表明，膝关节松动术后PPT的平均（95%可信区间）百分比增加（27.3%（20.9 - 33.7））显著大于手法接触后（6.4%（0.4 - 12.4））或非接触干预后（-9.6%（-20.7至1.6））。膝关节松动术还使远端非疼痛部位的PPT增加，并且与手法接触（-0.4%（-4.2至3.5））或非接触对照（+7.9%（2.6 - 13.2））干预相比，显著更多地缩短了“起身走”时间（-5%（-9.3至0.8））。因此，本研究提供了新的实验证据，即骨关节炎膝关节的附属松动术能立即产生局部和广泛的痛觉减退效果。因此，它可能是减轻该人群疼痛的一种有效方法。
