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治疗性超声对膝骨关节炎临床疗效的双盲试验。

A double-blind trial of clinical effects of therapeutic ultrasound in knee osteoarthritis.

作者信息

Ozgönenel Levent, Aytekin Ebru, Durmuşoglu Gulis

机构信息

Department of Physical Medicine & Rehabilitation, S.B. Istanbul Education and Research Hospital, Istanbul, Turkey.

出版信息

Ultrasound Med Biol. 2009 Jan;35(1):44-9. doi: 10.1016/j.ultrasmedbio.2008.07.009. Epub 2008 Oct 2.

Abstract

A randomized double blind clinical trial was conducted to determine the effectiveness of ultrasound (US) therapy in knee osteoarthritis (OA). Sixty-seven patients (mean age 54.8 +/-7) were randomized to receive either 1 MHz frequency or 1 watt/cm(2) power continuous ultrasound for 5 min (n = 34) or sham US (n = 33) as a placebo. Ten sessions of treatment were applied to the target knee of the patient. A blinded evaluation at baseline and after treatment was made. Primary outcome was pain on movement assessed by visual analog scale (VAS). Secondary outcomes consisted of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores and 50 meters walking time. Both groups showed significant improvements in knee pain on movement. In the treatment group, the improvement in VAS score was statistically and significantly higher (p < 0.001) and more pronounced than in the placebo group. Pain reduction averaged 47.76% in the treatment group (p = 0.013). Secondary outcomes improved in both groups but reached statistical significance only in the treatment group: p = 0.006 for the mean change in total WOMAC scores and p = 0.041 for 50 meters walking time. Results suggest that therapeutic US is safe and effective treatment modality in pain relief and improvement of functions in patients with knee OA.

摘要

进行了一项随机双盲临床试验,以确定超声(US)疗法对膝骨关节炎(OA)的有效性。67例患者(平均年龄54.8±7岁)被随机分为两组,一组接受1兆赫频率或1瓦/平方厘米功率的连续超声治疗5分钟(n = 34),另一组接受假超声(n = 33)作为安慰剂。对患者的目标膝关节进行10次治疗。在基线和治疗后进行盲法评估。主要结局指标是通过视觉模拟量表(VAS)评估的运动时疼痛。次要结局指标包括西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分以及50米步行时间。两组患者的膝关节运动疼痛均有显著改善。在治疗组中,VAS评分的改善在统计学上显著更高(p <0.001),且比安慰剂组更明显。治疗组的疼痛减轻平均为47.76%(p = 0.013)。两组的次要结局指标均有所改善,但仅治疗组达到统计学显著性:总WOMAC评分的平均变化p = 0.006,50米步行时间p = 0.041。结果表明,治疗性超声是缓解膝骨关节炎患者疼痛和改善功能的一种安全有效的治疗方式。

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