Jasiak-Tyrkalska Bozena, Frańczuk Bogusław, Jaworek Jolanta, Mosurska Daniela
Ortop Traumatol Rehabil. 2004 Aug 30;6(4):467-71.
Background. Given that obesity is the primary risk factor and pain the primary symptom of degenerative disease of the knee joint, we undertook to study the dependency between the Body Mass Index (BMI) and pain symptoms, and the impact of the BMI on the outcome of rehabilitation. Material and methods. Our research involved 38 patients with bilateral degeneration of the knee joint, according to the of the American College of Rheumatology (ACR). The patients were examined twice: at baseline before rehabilitation and immediately after a series of 10 procedures, as follow-up. Body build in terms of obesity was assessed on the basis of the BMI, according to WHO norms. The level of pain with and without loading on the limb was taken as the criterion for evaluating rehabilitation outcome. Pain level was evaluated using Likert's 11-point scale. Results. There was a statistically significant correlation (p<0.05 at baseline and p<0.01 at follow-up) between the BMI and the level of pain under load, but no significant correlation between BMI and pain when there was no load on the limb. The outcome was better in patients whose BMI was in the normal range or only somewhat above. Conclusions. Pain symptoms, especially when the limb is bearing weight, is significantly dependent on the BMI, which also has a major impact on rehabilitation outcome. Normalizing body weight should be a first-order priority in both the prevention and the rehabilitation of degenerative changes in the knee.
背景。鉴于肥胖是膝关节退行性疾病的主要风险因素，疼痛是其主要症状，我们着手研究体重指数（BMI）与疼痛症状之间的相关性，以及BMI对康复结果的影响。材料与方法。我们的研究纳入了38例根据美国风湿病学会（ACR）标准诊断为双侧膝关节退变的患者。患者接受了两次检查：康复前的基线检查以及在进行一系列10次治疗后立即进行的随访检查。根据世界卫生组织的标准，基于BMI评估肥胖程度的身体状况。以肢体负重和不负重时的疼痛程度作为评估康复结果的标准。使用李克特11点量表评估疼痛程度。结果。BMI与负重时的疼痛程度之间存在统计学显著相关性（基线时p<0.05，随访时p<0.01），但肢体不负重时BMI与疼痛之间无显著相关性。BMI处于正常范围或仅略高于正常范围的患者康复结果更好。结论。疼痛症状，尤其是肢体负重时的疼痛，显著依赖于BMI，BMI对康复结果也有重大影响。在膝关节退行性变的预防和康复中，使体重正常化应是首要任务。
