[一项针对老年膝骨关节炎患者采用运动干预的社区卫生服务项目的有效性：一项随机对照试验]

[Effectiveness of a community health service program using exercise intervention for elderly people with osteoarthritis of the knees: a randomized controlled trial].

作者信息

Oida Yukio, Morozumi Kazunori, Nakamura Nobuyoshi, Kitabatake Yoshinori, Shiozawa Shinichiro, Sato Shinichiro, Miura Kumiko, Nishi Akio, Itakura Masaya

机构信息

School of Life System Science and Technology, Chukyo University.

出版信息

Nihon Koshu Eisei Zasshi. 2008 Apr;55(4):228-37.

PMID:18536337

Abstract

OBJECTIVE

The objective of this study was to evaluate the effectiveness of an exercise program conducted as part of community health services to improve pain and physical function in elderly people with osteoarthritis of the knee (knee OA). METHODS; The subjects were 88 (12 males aged 77.8 +/- 5.4 years and 76 females aged 73.2 +/- 5.3 years) community-dwelling independent elderly people with knee OA who participated voluntarily in exercise classes sponsored by Musashino city of Tokyo. They were allocated randomly to the intervention group (n = 44) and the control group (n = 44). For the intervention group, exercise classes of 90 min duration were held 8 times over 3 months. The exercise program comprised flexibility exercises (stretching of knee and ankle joints), resistance exercises (strengthening of quadriceps, extension and flexion of the knee joint with an elastic band), and movement exercises (turning over, getting up, standing up). The subjects were instructed to perform these exercises at home every day. Knee pain scores (Western Ontario and McMaster Universities OA Index; WOMAC), peak torque of joint during knee flexion and extension, range of motion (ROM) of the knee joint, and functional fitness (standing and walking ability) were evaluated before and after the intervention period.

RESULTS

Significant inter-group differences were observed for peak torque during knee flexion and standing and walking ability of females. Assessment of interactions between time and group by repeated measure ANOVA adjusted for age and sex revealed significance differences for the WOMAC score (P = 0.031), the peak torque during knee extension (P = 0.016) and knee flexion (P = 0.000), ROM (P = 0.037), standing ability (P = 0.000)and walking ability (P = 0.000). The effect of the intervention was 0.44 for WOMAC score, 0.23 for peak torque during knee extension, 0.64 for knee flexion, 0.32 for ROM, 0.81 for standing ability, and 1.13 for walking ability.

CONCLUSIONS

These results suggested that the exercise program for elderly people with knee OA improved knee pain and physical function.

摘要

目的

本研究旨在评估作为社区卫生服务一部分开展的一项运动计划对改善老年膝骨关节炎（膝骨关节炎）患者疼痛和身体功能的有效性。方法：研究对象为88名（12名男性，年龄77.8±5.4岁；76名女性，年龄73.2±5.3岁）居住在社区的独立老年膝骨关节炎患者，他们自愿参加了东京武藏野市赞助的运动课程。将他们随机分为干预组（n = 44）和对照组（n = 44）。干预组在3个月内进行了8次时长90分钟的运动课程。运动计划包括灵活性练习（膝关节和踝关节伸展）、阻力练习（股四头肌强化、用弹力带进行膝关节屈伸）和动作练习（翻身、起床、站立）。指导受试者每天在家中进行这些练习。在干预期前后评估膝关节疼痛评分（西安大略和麦克马斯特大学骨关节炎指数；WOMAC）、膝关节屈伸过程中关节的峰值扭矩、膝关节活动范围（ROM）以及功能适应性（站立和行走能力）。结果：在女性膝关节屈曲时的峰值扭矩以及站立和行走能力方面观察到显著的组间差异。通过对年龄和性别进行调整的重复测量方差分析评估时间和组之间的相互作用，结果显示WOMAC评分（P = 0.031）、膝关节伸展时的峰值扭矩（P = 0.016）、膝关节屈曲时的峰值扭矩（P = 0.000）、ROM（P = 0.037）、站立能力（P = 0.000）和行走能力（P = 0.000）存在显著差异。干预效果在WOMAC评分方面为0.44，膝关节伸展时的峰值扭矩方面为0.23，膝关节屈曲时为0.64，ROM方面为0.32，站立能力方面为0.81，行走能力方面为1.13。结论：这些结果表明，针对老年膝骨关节炎患者的运动计划改善了膝关节疼痛和身体功能。