Silva Luciana E, Valim Valeria, Pessanha Ana Paula C, Oliveira Leda M, Myamoto Samira, Jones Anamaria, Natour Jamil
Rheumatology Rehabilitation Section, Division of Rheumatology, Federal University of São Paulo, São Paulo, Brazil.
Phys Ther. 2008 Jan;88(1):12-21. doi: 10.2522/ptj.20060040. Epub 2007 Nov 6.
This study was designed to evaluate the effectiveness of hydrotherapy in subjects with osteoarthritis (OA) of the knee compared with subjects with OA of the knee who performed land-based exercises.
Sixty-four subjects with OA of the knee were randomly assigned to 1 of 2 groups that performed exercises for 18 weeks: a water-based exercise group and a land-based exercise group. The outcome measures included a visual analog scale (VAS) for pain in the previous week, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), pain during gait assessed by a VAS at rest and immediately following a 50-foot (15.24-m) walk test (50FWT), walking time measured at fast and comfortable paces during the 50FWT, and the Lequesne Index. Measurements were recorded by a blinded investigator at baseline and at 9 and 18 weeks after initiating the intervention.
The 2 groups were homogenous regarding all parameters at baseline. Reductions in pain and improvements in WOMAC and Lequesne index scores were similar between groups. Pain before and after the 50FWT decreased significantly over time in both groups. However, the water-based exercise group experienced a significantly greater decrease in pain than the land-based exercise group before and after the 50FWT at the week-18 follow-up.
Both water-based and land-based exercises reduced knee pain and increased knee function in participants with OA of the knee. Hydrotherapy was superior to land-based exercise in relieving pain before and after walking during the last follow-up. Water-based exercises are a suitable and effective alternative for the management of OA of the knee.
本研究旨在评估水疗对膝骨关节炎（OA）患者的有效性，并与进行陆上运动的膝OA患者进行比较。
64名膝OA患者被随机分为两组，进行为期18周的运动：水基运动组和陆上运动组。结局指标包括前一周疼痛的视觉模拟量表（VAS）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）、通过静息VAS和50英尺（15.24米）步行测试（50FWT）后立即评估的步态疼痛、50FWT期间以快速和舒适步速测量的步行时间以及勒凯斯内指数。测量由一名盲法研究者在基线以及干预开始后的第9周和第18周记录。
两组在基线时所有参数均具有同质性。两组之间疼痛减轻以及WOMAC和勒凯斯内指数评分改善情况相似。两组在50FWT前后的疼痛随时间均显著降低。然而，在第18周随访时，水基运动组在50FWT前后的疼痛减轻程度明显大于陆上运动组。
水基运动和陆上运动均能减轻膝OA参与者的膝关节疼痛并提高膝关节功能。在最后一次随访中，水疗在缓解步行前后的疼痛方面优于陆上运动。水基运动是治疗膝OA的一种合适且有效的替代方法。
